![]() "So we do hear frustration, and it is really important to understand that the starting point people have is that they're already feeling overworked. "We have to recognize that physicians begin this already with a significant amount of change fatigue and a significant amount of paperwork," he said. Slavitt said CMS has already cut the number of quality measures by a third in MACRA, and they are looking for even more. "This is where it is really important for us to create flexibility to allow physicians to define what quality means for them, for their practice, for their patients and for their specialty."įinally, the public comment period yielded pleas to help streamline and simplify wherever possible. Second, Slavitt said physicians want a sense of control and flexibility rather than one-size-fits-all program out of Washington. This includes the bonus opportunities within the legislation, like a 5 percent bonus opportunity for participating in certain payment models. Overall, three themes have emerged from those conversations.įirst is a demand for allowing physicians to be patient-centered, and focusing on the benefits and results of care coordination and quality. ![]() Slavitt said CMS has received more than 4,000 formal comments and had hundreds of conversations with physicians and other stakeholders in the last few months. Slavitt asked the industry for robust public comment on the proposed rule and he certainly got what he asked for. So the law really takes a step in shifting the payment equation from one that has them searching for codes they can bill for to one that allows them to do the job of being a doctor," Slavitt said. "We know that much of the good work that physicians do isn't about a test or a prescription, but rather it's the time they dedicate to spending with us as patients to really talk to us about our options and understand our health better. ![]() If the law, which already is more than 900 pages long, doesn't become too complicated, Slavitt said it will lead to better care and happier doctors. We found out the five questions every healthcare provider must ask before jumping in to MACRA. MACRA, according to Slavitt, took the successful lessons learned in payment experiments like patient-centered medical homes, bundled payments and team-based models like accountable care organizations, and move them into the mainstream "by taking what works and adding some additional options for physicians who get better results," he said. "I don't think anybody would say they're happy with the way healthcare payments work today," Slavitt said. The new rule passed with overwhelming bipartisan support last year. MACRA was designed to replace the sustainable growth rate formula, or "Doc Fix," which Slavitt said required too many last-minute fixes to what would have been significant reductions in physicians' pay. ![]() "The legislation itself isn't our destiny, it just lays out a framework." "Legislation always gives us the opportunity to make historic shifts in the healthcare system and in our programs," he said. Healthcare Finance recently spoke with Slavitt about MACRA and the benefits he sees in the law changes. He's already been called to testify in front of Congressional committees about the benefits of the law change, and is currently weighing more that 4,000 formal comments about the law. Perhaps nobody carries the burden of calming those fears more than Andy Slavitt, acting administrator of the Centers for Medicare and Medicaid Services. But the marrying of quality-based reimbursement with demonstrated use of technologies and electronic health records has already sparked worry among not only physicians, but advocates like the American Medical Association and the American Academy of Family Physicians. The Medicare Access and CHIP Reauthorization Act, known as MACRA, will be one of the most dramatic changes to how Medicare pays physicians.
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