The rule implementing the new Medicare physician quality payment program called for by the Medicare Access & CHIP Reauthorization Act of 2015 (MACRA) presents challenges and opportunities for hospitals, health systems and the nearly 540,000 directly employed or contracted physicians with whom they partner to deliver quality care. The Centers for Medicare & Medicaid Services’ release of the final MACRA rule represents the next evolution in value-based health care. With 2017 rapidly approaching, hospitals and their clinician partners need to understand how to prepare and how their current population health and clinical activities align toward safer, better and smarter care.
In an effort to highlight the key provisions of the new physician payment system for hospitals, clinicians and trustees, the AHA has developed a MACRA 101 video series including small, bite-sized “MACRA Minutes.”
Moderated by AHA’s Committee on Clinical Leadership Chairman Kevin Most, D.O., vice president of Medical Affairs & CMO, Northwestern Medicine Central DuPage Hospital, the first series provides a high-level policy perspective on the new payment program, while the second series features three physician leaders discussing educational strategies for physicians that hospital administrators could consider using. Both sets of videos also are available in short, digestible nuggets that are suitable for a quick download.
The video series explores the program’s two “tracks” — the Merit-based Incentive Payment System (MIPS), and incentives for clinicians who demonstrate significant participation in alternative payment models, or APMs. Some of these include next generation ACO, certain bundled payments, and Patient Centered Medical Home. Under MIPS, clinicians will be measured on their performance related to quality, cost, clinical practice improvement activities and advance care information (formerly known as meaningful use of electronic health records (EHR)). They will earn rewards or penalties, based on performance. In contrast, the APM track allows physicians who receive a significant portion of their payments through eligible APMs to be exempt from most MIPS quality reporting provisions, and through 2024, to receive a bonus. Eligible APMs must require use of certified EHR technology, tie provider payments to quality performance, and hold participants accountable for paying back a portion of their losses to Medicare if their spending exceeds certain targets.
As hospitals work more closely with clinicians, they will need tools and resources to strengthen patient health outcomes, ensure financial stability and succeed as part of a truly coordinated system that enables clinicians to focus on caring for patients. The AHA and its Physician Leadership Forum are ready to support the needs of the health care field as we implement MACRA’s sweeping changes. The MACRA 101 video series is just one of many resources available at www.aha.org/MACRA. In addition, please join me and the AHA’s policy experts for a webinar on Nov. 3 at 3 p.m. ET as we analyze the final rule and discuss steps to take now. Register by clicking here. Finally, watch for more information and tools in the coming weeks and months that will support the field through MACRA implementation. We are your trusted voice, trusted resource and trusted partner.