MACRA: Good, Bad, or Downright Ugly for Physicians?

TMA and Texas physicians cheered when Congress repealed Medicare's Sustainable Growth Rate (SGR) formula last year. The Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) not only removed the constant threat of Medicare payment cuts, but it also promised to simplify the ever-tightening thicket of federal regulations that strangle physicians' practices.  

TMA is less than enthusiastic, however, about the Centers for Medicare & Medicaid Services' (CMS') plans to implement the new law. TMA is studying the 426 pages of proposed MACRA regulations carefully and sent TMA chief lobbyist Darren Whitehurst and Angie Ybarra, TMA's director of clinical advocacy, to Washington for in-depth discussions with the American Medical Association and national specialty societies. A TMA staff team listened carefully to two MACRA briefing sessions that AMA set up with CMS officials. 

According to TMA Chief Executive Officer Louis J. Goodman, PhD, here are the association's topline observations so far: 

  • MACRA is far more complex, confusing, and controlling than the Physician Quality Reporting System, meaningful use, and value-based modifier programs it is replacing.
  • Compliance will be especially difficult for small practices that may end up with Medicare payment penalties, even if they spend the time and money to jump through all the new regulatory hoops.
  • The system of bonuses and penalties pits physician practices against one another so that there will be winners and losers, regardless of how well all practices "perform" on these new quality standards. 

TMA needs physician feedback (email macra[at]texmed[dot]org) as it develops detailed official comments on the draft regulations. In the meantime, the association urges physicians from practices of all sizes to visit TMA's MACRA Resource Center to learn about the new law and proposed regulations.

In addition, read "Bracing for MACRA" in the July issue of Texas Medicine to learn about the new quality-based payment pathways Congress designed to replace the SGR and how TMA is helping practices navigate the labyrinthine Medicare payment paradigm. 

Action, June 1, 2016

Last Updated On

October 11, 2016

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