Statement on MACRA Final Rule

Tom Nickels
Executive Vice President, Government Relations and Public Policy
American Hospital Association

Today’s final Medicare Access & CHIP Reauthorization Act of 2015 (MACRA) rule presents challenges and opportunities for hospitals and health systems, and the nearly 540,000 directly employed or contracted physicians with whom they partner to deliver quality care.

While we are disappointed that CMS continues to narrowly define advanced alternative payment models (APMs), which means that less than 10 percent of clinicians will be rewarded for their care transformation efforts, we are encouraged that CMS is exploring a new option that would expand the available advanced APMs that qualify for incentives. We urge CMS to ensure that this option be available in 2017 and look forward to working with them so this new model achieves an appropriate balance between risk and reward.

We are pleased that CMS has provided clinicians with increased flexibility to meet MACRA’s aggressive timelines and reporting requirements. By allowing them to “pick their pace,” clinicians in a variety of settings will be able to more easily transition to the new program. Furthermore, CMS’s final measures for the advancing care information category of the Merit-based Incentive Payment System (MIPS) offer some welcome relief from the overly aggressive initial proposal.

At the same time, the AHA remains concerned that the lack of sociodemographic adjustment to the measures used in the MIPS will unfairly disadvantage clinicians and hospitals caring for the poorest patients. Opportunities also remain to further align hospital and clinician performance measurement, and we will work with the agency to make that happen.

We continue to review the details of the final rule and will provide guidance to hospitals and their clinician partners. As implementation moves forward, we remain committed to making sure patients benefit from the transformation of care envisioned by MACRA.

About the AHA

The AHA is a not-for-profit association of health care provider organizations and individuals that are committed to the health improvement of their communities. The AHA is the national advocate for its members, which include nearly 5,000 hospitals, health care systems, networks, other providers of care and 43,000 individual members. Founded in 1898, the AHA provides education for health care leaders and is a source of information on health care issues and trends. For more information, visit the AHA website at www.aha.org.