HHS' Office of the Inspector General (OIG) has highlighted 2 vulnerabilities during the analysis of how CMS (Centers for Medicare and Medicaid Services) has managed the rollout of the Medicare Access and CHIP Reauthorization Act (MACRA) so far that must be dealt next year.
In accordance to OIG, however overall development has been "important" in executing MACRA — the law that reforms how physicians are paid under Medicare Part B — most of the work is yet ahead. The first performance year begins on Jan. 1, which will determine payments for 2019.
The 2 areas CMS should concentrate on next year to make MACRA successful are ensuring clinicians have enough guidance and technical help, and establishing backend information technology systems to support the level of data submission, validation and calculation needed by the program, according to OIG. The OIG considers dealing these two elements as crucial to the success of program.
The OIG interviewed CMS staff and analyzed internal documents and publicly available information in order to evaluate the progress of agency. The OIG discovered CMS, which "has historically confronted issues and challenges when executing complex initiatives of this size," has initiated to learn from its previous mistakes, specifically those it faced in the HealthCare.gov rollout.
An unnamed CMS official quoted in the report, "HealthCare.gov was an actually low moment for the agency, but it was a learning moment, which permitted us to learn the lessons of how to build new muscles [from the turnaround of] HealthCare.gov and implement them to the MACRA program.”
For further information, read the full progress report here.