Concerns About MACRA

Source: Oncology Times 

At a recent briefing on Capitol Hill sponsored by the Alliance for Health Reform, several speakers expressed their concerns about potential unintended consequences of Medicare value-based care; the Medicare Access and CHIP Reauthorization Act (MACRA) will implement new regulations on Medicare value-based payment in 2017. A major concern is that MACRA could accelerate consolidation of health care providers and create difficult challenges for small practices. CMS must “provide protection for smaller independent practices to meet regulatory requirements and mitigate further provider consolidation under MACRA,” said Donald R. Fischer, MD, MBA, a health care consultant who recently retired as Senior Vice President and Chief Medical Officer at Highmark Blue Cross Blue Shield. If small practices that serve disadvantaged Medicare patients are not protected, it could be especially devastating for their patients.

A new report from the National Center for Policy Analysis (NCPA), a nonprofit, nonpartisan public policy research firm, also has major concerns about how MACRA could adversely affect Medicare beneficiaries. For consumers, MACRA’s increased federal control over the practice of medicine could translate into “higher costs and more difficulties getting access to timely and quality care,” warned NCPA Senior Fellow John R. Graham, MBA.

The views and values of all patients must always be considered and honored in value-based payment reform, said other speakers at the Capitol Hill briefing.

“Patients and families should be viewed as partners in all [payment] transformation efforts, from point of care to governance,” emphasized Stephanie Glover, MPA, Health Policy Analyst with the National Partnership for Women & Families, a nonprofit, nonpartisan advocacy group dedicated to promoting access to quality health care, among other aims. She said alternative payment models “should be built upon a strong foundation of robust consumer protections that ensure consumer needs are met and that safeguard consumer rights and access to care.”

Glover added, “As CMS continues to develop new models of care and payment and providers take on increased risk, reward and responsibility, the agency must ensure that the evolution and application of consumer safeguards are keeping pace.” Safeguarding patients’ rights and assuring access to care is especially important when providing treatment to the most vulnerable populations in the nation.

Medicare quality measurement and reporting should be “meaningful, actionable and transparent to consumers, patients and family caregivers,” Glover emphasized. And, she said, quality-measure data sets “should include the use of measures derived from patient-generated data that address both care experience and outcomes.”

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