CMS agrees with complaints about MACRA

Agency will ask providers for ideas to measure outcomes

A top CMS official agrees with a congressional advisory panel that MACRA’s payment model should focus more on outcomes and less on performance and says the agency will seek input from providers on changing the measurements.

The Medicare Payment Advisory Commission last week said that MIPS, the Merit-based Incentive Payment System created by MACRA, should be repealed because it weighs too heavily on how doctors perform, such as whether they ordered appropriate tests or followed general clinical guidelines, rather than if patient care was ultimately improved by that provider’s actions. It argues the payment system won’t push physicians to truly improve outcomes and should be replaced.

Dr. Kate Goodrich, chief medical officer of CMS’ Center for Standards and Quality said on Friday that she agreed with the criticism but did not go so far in saying MIPS should be repealed.

“There are more outcomes measures in the MIPS portfolio than I think people realize, but it is still too heavily weighted on process measures” Goodrich said at a MACRA summit.

The agency’s disinterest in an outright repeal of MIPS, which was created by a GOP-controlled Congress during the Obama administration, is good news for providers who view the program as a way to get more Medicare payments in the near term, according to Dr. Michael Munger, president of the American Academy of Family Physicians. Under MIPS, doctors can earn a bonus or penalty of 4% of their reimbursement in 2019. It’s unclear how soon it would take to get bonus payments under a replacement model.

MedPac proposed that instead of MIPS, all Medicare physicians remaining in fee-for-service should have

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