With MACRA underway, all eyes are on 2017

This is the year to watch for the Medicare Access and CHIP Reauthorization Act of 2015, or MACRA, and all eyes are on how the law will change the landscape of physician care.

But so far, so good.

Speaking at a panel discussion on the law and its future at the 2017 HIMSS conference, Centers for Medicare and Medicaid Studies Chief Medical Officer Kate Goodrich said one of MACRA's signature features, the Quality Payment Program, is still a bit of a learning process for providers, but the health care sector is starting to take hold of the process.

"So it’s early," she said. "People are still, I think, getting up to speed and learning what the rules of the road are. We are getting a lot of feedback that people are starting to understand what they are supposed to do."

Providers started submitting QPP data on Jan. 1 to help shape their Medicare payment adjustments in 2019 through two payment models: The Advanced Alternative Payment Model and the Merit-based Incentive Payment System.

The MIPS model requires providers to submit data to Medicare if they bill more than $30,000 a year and provide care for more than 100 Medicare patients a year, but will allow physicians to determine their pace of adoption ahead of a March 31, 2018 deadline.

The more data a provider submits, the bigger the Medicare payment they will receive.

For the Advanced APM model, providers who get 25 percent of Medicare payments or see 20 percent of Medicare patients through an Advanced APM in 2017, they have a chance at a 5 percent incentive in 2019, with a potential for 9 percent in 2022.

Goodrich said though providers have been working their way through the new reporting requirements, most are embracing them as a way to move to the more merit-based platform.

"One thing that’s been nice to hear is that a lot of folks really want to try to do more," she said. "We definitely expect that we will have some folks that will do the minimum amount and they’re just not ready to go beyond that, but even with folks who haven’t participated previously, we are hearing they want to at least try to do more than the bare minimum."

Goodrich added that CMS will start notifying providers of the status of their MIPS eligibility in the next four to six weeks.

ONC looks ahead

Acting ONC Director Jon White also talked about the office’s goals for 2017 and how it plans to move interoperability forward under the Trump administration and new Secretary for Health and Human Service Tom Price.

"We are collaborating closely with our colleagues in the new administration to deliver IT priorities in areas of focus," he said. "There are two very clear priorities for us. The first is to reduce the burden of health IT use on providers and the second is to achieve widespread interoperability within health IT."

White added that those priorities came from Price, but ONC will also focus on implementing the 21st Century Cures Act — a 2016 law that authorizes research using protected health data — in addition to working on its data standards for the Precision Medicine Initiative.

The ONC director added that while interoperability’s stakeholders — both in the tech sector and in the medical field — are fully invested in moving forward to use health IT to move health care toward outcome-based measures, the journey is far from over.

"Nobody wants to go back to paper," he said. "They all say ‘Look, we see a lot of benefits to this information system, we’ve got data available to us that we’ve not had before.’ They also vent their frustrations.

"This is not a once-and-done deal. This is an ongoing process."

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