On April 27, 2016, the Department of Health and Human Services issued a Notice Executive of Proposed Rulemaking to implement key provisions of the Medicare Access and Summary CHIP Reauthorization Act of 2015 (MACRA), legislation that repealed the Sustainable Growth Rate formula and replaced it with the “Quality Payment Program."  This proposed rule requires physicians to participate in either the Merit-based Incentive Payment System (MIPS) or the Advanced Alternative Payment Models (APMs).  More information about these two programs can be found here.  Included below are MedChi's letter and the AMA's letter to Acting Administrator Andrew M. Slavitt addressing our concerns with this proposed rule.

• Medicare Access and CHIP Reauthorization Act (MACRA) and Merit-based Incentive Payment Systems (MIPS)
• MedChi Letter to Andrew M. Slavitt, Acting Administrator, Centers for Medicare & Medicaid Services Department of Health and Human Services
• AMA Letter to Andrew M. Slavitt, Acting Administrator, Centers for Medicare & Medicaid Services Department of Health and Human Services

• The AMA Payment Model Evaluator is an innovative tool offering initial assessments to physicians so they can determine how their practices will be impacted by the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA). Developed with the expertise of physicians and input from partners, the tool will give physicians and their staff a brief assessment, as well as relevant educational and actionable resources. Once physicians and medical practice administrators fill out the online questionnaire, they will receive guidance for participating in the MACRA payment model that is best for them. The AMA will continually update the Payment Model Evaluator to respond to regulatory changes and to keep practices up to date throughout the new payment and care delivery reform process. The tool is free to all physicians and their practice administrators.

• The AMA STEPS Forward™ collection of practice improvement strategies has new MACRA-specific tools. Accurate and successful reporting on quality metrics is crucial to the new Medicare payment system, both in the current Physician Quality Reporting System program and under MACRA’s new Quality Payment Programs. Each STEPS Forward module focuses on a specific challenge and offers real-world solutions, steps for implementation,, case studies, continuing medical education, and downloadable tools and resources. Physicians and their practice staff can use these to help improve practice efficiency and ultimately enhance patient care, physician satisfaction and practice sustainability. The full collection, which now includes 42 modules, has a variety of tools that will help physicians and their practices, including:

• Implementing team-based care
• Electronic health record selection and implementation
• Preparing practices for value-based care
• Implementing team documentation
• Quality Reporting and the importance of Qualified Clinical Data Registries (QCDRs) in maximizing your success 

• The AMA launched a ReachMD podcast series titled Inside Medicare’s New Payment System.  Andy Slavitt, acting administrator of the Centers for Medicare and Medicaid Services (CMS), Dr. Gurman, AMA staff experts, and others are featured on the series, which will include five episodes to help physicians be informed on upcoming Medicare changes. 

The Center for Medicare and Medicaid Services (CMS) is slated to release the final Medicare rule by Nov. 1. The AMA will provide additional information at that time.

Learn more on AMA Wire® about these tools or check out other key changes to the Medicare payment system.