Source: AAFP News, October 14, 2016, © American Academy of Family Physicians
It’s been a long six months of anticipation for America’s family physicians but on October 14 the U.S. Department of Health and Human Services (HHS) released the long-awaited final rule that will implement MACRA.
“Today, we’re proud to put into action Congress’ bipartisan vision of a Medicare program that rewards clinicians for delivering quality care to their patients,” HHS Secretary Sylvia Burwell said in a press release.
She noted that the implementation vehicle for the rule, called the Quality Payment Program was “designed with input from thousands of clinicians and patients across the country.”
Indeed, the American Academy of Family Physicians worked tirelessly to steer the crafting of the final rule with an eye to supporting and protecting the key role family physicians play in the nation’s health care system.
“The final rule addresses many of the concerns family physicians have expressed about the complexity of the program, the pace of implementation, new administrative burdens, and the usability of technology,” AAFP President John Meigs, MD, of Centreville, AL., said in a statement.
“In particular, we are pleased that practices with low volumes of Medicare Part B patients are excluded in the first year and that family physicians will be able to move toward full participation without suffering penalties that will slow their progress,” he added.
HHS Secretary Burwell asserted that implementation of the Quality Payment Program would “strengthen our health care system for patients, clinicians, and the American taxpayer.”
Centers for Medicare and Medicaid Services (CMS) Acting Administrator Andy Slavitt pointed to the rule’s built-in flexibility aimed at allowing physicians to work at their own pace.
“Today’s policies are deigned to get all eligible clinicians to participate in the program so they are set up for successful care delivery as the program matures,” he said.
AAFP Responds to Final Rule
For months the AAFP worked to shape MACRA into a tool that rewards family physicians for all the work they do to provide comprehensive care to their patients. Although AAFP experts are just beginning to analyze the final rule to prepare family physicians for its implementation, Dr. Meigs noted that it appears to take into account the Academy’s guidance.
He gave a nod to the provisions in the rule designed to “smooth the way” for physician participation in the Merit-Based Incentive Payment System (MIPS) and alternative payment models (APMs).
“We’re particularly pleased the rule implements and provides additional clarification regarding the ‘pick your pace’ system that allows practices to choose their reporting timeline for participating in the MACRA Quality Payment Program,” said Dr. Meigs.
Small and solo medical practices would particularly benefit from the provision, he noted. And other flexibilities such as exemptions from certain penalties and allowances for patient-centered medical homes “will help low-volume practices.”
The rule also provides for $20 million in funding spread over five years to help train and educate physicians and other Medicare providers about all elements of the Quality Payment Program.
“This uniquely tailored assistance will help family physicians in individual or small group practices — as well as those working in underserved areas — identify appropriate technologies and quality measures, and help them evaluate their options for joining an Advanced APM.
Most importantly, said Dr. Meigs, the kind of support outlined in the rule “will allow physicians to focus on what they do best — taking care of patients.”
Utilize AAFP Resources, Succeed In New Payment Models
The AAFP has invested a significant amount of time and energy toward ensuring that family physicians are armed with everything they need to succeed in the value-based payment models under construction.
One of the AAFP’s most popular resources is a frequent-asked-question document that gets to the nub of what physicians want to know about a very intricate and complicated program. For instance, the very first question asks how MACRA will affect a physician’s Medicare payments. It also answers questions about MIPS, APMs, and implications for small practices. Check out this and a number of other tools that are ready and waiting from the AAFP.
MACRA Background
HHS released the proposed MACRA rule and April, and eight weeks later, after a meticulous review, the AAFP let the agency know that its proposal had missed the mark. In a 100-plus page comment letter, the AAFP laid out its view of how CMS could rein in the massive rule to make it workable for family physicians.
In last week’s statement, Dr. Meigs said, “The AAFP made several suggestions in response to the proposed rule, and we’ll closely analyze the final regulation to identify CMS action on those comments.”
He added that the AAFP’s initial review of the final rule “indicates CMS has addressed many of its comments — especially in regard to support for small practices.”
Notably, HHS designated last week’s release as the “final rule with comment period” — a designation that gives the AAFP and other interested stakeholders the opportunity to provide HHS with further input.
Watch future editions of the Weekly Family Medicine Update for more reaction from the AAFP after Academy experts have time to scrutinize details of the entire rule.