Proposed Medicare Payment Changes Designed to Meet Providers’ Needs

The proposed rule guiding the new Medicare payment system was driven by physician input, Andy Slavitt, acting administrator of the Centers for Medicare & Medicaid Services told attendees at the 2016 American Medical Association (AMA) annual meeting in Chicago last month, according to a report from AMA Wire. 

As a result, Slavitt said many of the changes aim to promote themes physicians and other health care providers consider important: patient-centered care, flexibility, success for small practices and those in underserved areas, and simplification.

Comment on the proposed rule for the Medicare payment system under the Medicare Access and CHIP Reauthorization Act (MACRA) closed June 27. Slavitt told the AMA crowd the opportunity to change how Medicare pays for health care is a historic one.

“I’m also here to talk about something bigger: Reversing a pattern of regulations and frustration and ultimately unleashing a new wave of collaboration between the people who spend their lives taking care of us and those of us whose job it is to support that cause,” Slavitt said in the AMA Wire report.

The new system aims to keep patients at the center of care through alternative payment models such as accountable care organizations, which currently serve more than 9 million beneficiaries, according to Slavitt.

The Merit-Based Incentive Payment System, or MIPS, “is intended to move the focus to patients as well,” Slavitt reportedly added. “There are more than 90 clinical practice improvement activities for physicians to choose from, which support patient-friendly steps.”

The new system offers flexibility to practices by providing options, such as whether or not to participate in alternative payment models. The proposed rule was also designed with the needs of small practices in mind, Slavitt said. A schedule included in the proposed rule specifically highlights the disadvantage such practices would face by choosing not to report quality measures.

“Under the quality payment program, we know that physicians in small practices who report performance can do equivalently well as mid-sized practices,” Slavitt reportedly told the crowd. “We are committed to significantly reducing the financial cost and the burden of reporting.”

Finally, the new system promoted simplification by connecting together several programs and reducing reporting demands—even if it may not seem that way at first glance.

“One reason we think we’re hearing some concern from physicians is that it’s the first time the entirety of these programs can be seen end-to-end in one place,” Slavitt said, according to the AMA Wire report.

“We’ve reduced by one-third the number of quality metrics that need to be reported …We simplified the process … [and] we made it so the programs talked to each other.”—Jolynn Tumolo