CMS issues final MACRA rule for updating Medicare payment

​The Centers for Medicare and Medicaid Services (CMS) issued a final rule for its new payment system developed by MACRA on the Friday morning, offering higher certainty for physicians on the descriptions of the new system.

“In small or physician-owned practices, a major number of osteopathic physicians work, which are the most susceptible to shifts in federal payment,” claims AOA President Boyd R. Buser, DO. “The new MACRA rule will straightly impact about 50 percent of our members as we are anticipating. The final rule’s announcement provides them the certainty required to plan their approach to the latest payment system and many of our physicians’ concerns with the transition are addressed by this rule.”

Background of MACRA 
As it was approved in April previous year, the Medicare Access and CHIP Reauthorization Act (MACRA) of 2015 repealed the Medicare sustainable growth rate formula (SGR), which the CMS had utilized as a basis for calculating physician payment. A new Medicare payment system designed to emphasize quality of care was also established by MACRA.

On the basis of new payment system, physicians will select between utilizing the Merit-Based Incentive Payment System (MIPS), or an approved Alternative Payment Model (APM). 3 existing Medicare quality reporting programs is being streamlined by MIPS and add a 4th category for practice improvement. APMs are basically the payment systems that strongly reward quality of care.

Significant flexibility of physicians is being offered by CMS on their level of participation with the new payment system throughout the year of 2017, involving how and when they start reporting.

Final rule
The AOA is disappointed that several physicians who practice in patient-centered medical homes will yet not be applicable for the APM path, but appreciates the provisions of final rule that will permit small and rural practices in future to make virtual groups to better position themselves to acquire MIPS bonuses.

The AOA is also motivated that physicians have been provided “pick your pace” choices for the very 1st year, which will offer them time to adjust to the latest system. The year of 2018 will have extra accommodations as physicians continue to get used to the new system, CMS noted.

AOA has been a core part of ensuring that MACRA works for osteopathic physicians at every step of the way. However, among other actions, the AOA has:

• Hosted a MACRA Town Hall at AOA’s House of Delegates for DOs to participate with CMS Acting Administrator Andy Slavitt.
• Established resources for osteopathic physicians to prepare for this important transition.
• A multi-stakeholder letter was sent to the Administration promoting the Patient-Centered Medical Home (PCMH).
• Arranged hundreds of meetings with policymakers—both during the development of MACRA and throughout implementation.
• Assisted shape future Physician-focused Payment Models (PPMs).

For further information on MACRA and its upcoming developments, please visit osteopathic.org/MACRA.