The federal government needs to kick it in gear and release funds for "the development of quality measures and technical assistance to small practices" authorized by the Medicare Access and CHIP Reauthorization Act (MACRA). That's the gist of an Oct. 7 letter from the American Medical Association to Centers for Medicare & Medicaid Services (CMS) Acting Administrator Andrew Slavitt. TMA signed on to the letter in support of expeditious release of the critical funding.
Come 2019, physicians can participate in one of two major payment tracks: the fee-for-service Merit-Based Incentive Payment System (MIPS), which boosts or docks physician pay based on their quality and cost performance, or one or more alternative payment models (APMs), such as accountable care organizations, medical homes, bundled payments, or other initiatives.
"We have repeatedly called for federal funding to support quality measure development and were pleased that MACRA included funding for this purpose (section 102) as well as additional funding for technical assistance to help small practices comply with requirements of the [MIPS] and/or transition to an alternative payment model (section 101). Key to achieving the legislation's goals is the availability of an adequate portfolio of appropriate quality measures, along with meaningful technical assistance to practices that meet the needs of the various physician specialties for improving the care of their patients," the letter states.
The AMA letter cites MACRA's authorization of funding to the tune of "$15 million per year for each of fiscal years 2015 through 2019, for a total of $75 million, to fund the development of physician quality measures for use in the MIPS." MACRA also authorizes "$20 million per year from fiscal years 2016 through 2020 for technical assistance to small practices of up to 15 professionals — especially those in rural areas, health professional shortage areas, and medically underserved areas." To date, the government hasn't released those funds.
"We are therefore troubled by HHS' lack of expediency in addressing this critical need, especially in view of the fact that adjustments under MACRA's [MIPS] are likely to be based on a performance year that begins on January 1, 2017, and the CMS deadline for measures to be considered for the 2017 reporting period closed in June," the letter states.
TMA, AMA, and dozens of state and national organizations call on CMS to promptly release funds to support development of "actionable and relevant measures that improve patient care and allow physicians to comply with the program" and for the U.S. Department of Health and Human Services to "partner with state and specialty medical societies on this initiative. Medical societies are trusted sources of information and guidance within the physician community, and their involvement in technical assistance initiatives would ensure active and direct physician engagement."
For more about the new payment systems that will replace Medicare's Sustainable Growth Rate formula, read "SGR Is Gone. Now What?" in the September issue of Texas Medicine.
Action, Oct. 15, 2015