MESSAGE FROM THE PRESIDENT

MACRA: STILL A WORK IN PROGRESS

The final rule for MACRA payment reform on how the government reimburses physicians by tying treatment to quality measures has been announced.

And thanks to collaboration with physician- stakeholders, MACRA will be eased into practices across the country.

The Medicare Access and CHIP Reauthorization Act of 2015, known as “MACRA,” is already a significant departure from a lot of federal policy in that it was bipartisan and passed into law last year by a Republican-controlled Congress and signed into law by Democratic President Barack Obama whose healthcare policies are key talking points for the GOP in this year’s election.

When MACRA payment reforms were proposed, physicians were worried these landmark measures and reimbursements would come without the input of organized medicine. The head of the Centers for Medicare and Medicaid Services even came last summer to Chicago to address the American Medical Association’s House of Delegates.

At that time, CMS Administrator Andy Slavitt told AMA delegates he wanted to “make it clear” that MACRA is a “constant request for feedback and the need to improve will continue.”

“Things won’t change overnight,” Slavitt told hundreds of physicians gathered at the Hyatt. “The first year of this new program will hit bumps as new policies run into the realities of everyday medicine. Systems will need to adapt to your needs.”

Slavitt stayed true to his word by working in collaboration with medical societies across the country including the AMA. In announcing the final rule, Slavitt reported that CMS received over 4,000 comments and that nearly 100,000 people attended outreach sessions, which he described as “record levels of clinician engagement.”

As a result of these collaborative efforts, MACRA’s final rule allows physicians to participate “at their own pace.”

“The first couple of years are aimed at getting physicians gradually more experienced with the program and vendors more capable of supporting physicians,” Slavitt said in a letter he wrote to providers in October. “We have finalized this policy with a comment period so that we can continue to improve the program based on your feedback.”

My point in describing the final rule is that the federal government listened because physicians were engaged and collaborated. They got the message because doctors didn’t draw a line in the sand.

There’s bound to be headaches with MACRA, but CMS is taking input all along the way.

And we must remember that MACRA repealed the flawed sustainable growth rate (SGR) formula that we complained about for years because it cut payments to doctors’ practices. The SGR, which was part of the Balanced Budget Act of 1997, created 17 cuts to physician Medicare reimbursement.

We want to keep CMS administrators involved, along with our lawmakers from Washington and Springfield to Chicago’s City Hall. I encourage you to contact me or the Medical Society office either directly or through our online community to share your concerns and ideas on issues over this next year. Let’s not stop at MACRA.

Clarence W. Brown, Jr., MD
President, Chicago Medical Society