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CMS Rule Simplifies Quality Payment Program Requirements

CMS responded to clinicians’ concerns about complex reporting requirements and issued a proposed rule simplifying the Quality Payment Program.

Quality Payment Program

Source: Thinkstock

By Kate Monica

- CMS yesterday issued an unpublished version of a proposed rule modifying the second year of the Quality Payment Program (QPP), as required by MACRA, in an effort to simplify the program.

Simplifying QPP will benefit small, independent, and rural practices in particular.

It will also support the fiscal sustainability and quality of care within Medicare according to a recent press release issued by CMS.

These changes follow requests from several healthcare organizations to simplify the requirements part of the federal program.

“We’ve heard the concerns that too many quality programs, technology requirements, and measures get between the doctor and the patient,” said CMS Administrator Seema Verma. “That’s why we’re taking a hard look at reducing burdens.”

“By proposing this rule, we aim to improve Medicare by helping doctors and clinicians concentrate on caring for their patients rather than filling out paperwork,” Verma continued. “CMS will continue to listen and take actionable steps towards alleviating burdens and improving health outcomes for all Americans that we serve.”

The QPP is updated annually under MACRA. The program is designed to encourage the healthcare system to place more of a focus on value over volume in care delivery as part of the industry’s transition to value-based payment models.

Presently, over 57 million seniors receive care from clinicians participating in Medicare.

Clinicians have the option to choose how to participate in QPP depending on factors such as practice size, specialty, location, and patient population.

“The proposed rule would amend some existing requirements and also contains new policies for doctors and clinicians participating in the Quality Payment Program that would encourage participation in either Advanced Alternative Payment Models (APMs) or the Merit-based Incentive Payment System (MIPS),” stated Verma.

The proposed rule is set to be published on June 30, 2017.

“Additionally, CMS has used clinician feedback to shape the second year of the program,” she said. “If finalized, the proposed rule would further advance the agency’s goals of regulatory relief, program simplification, and state and local flexibility in the creation of innovative approaches to healthcare delivery.”

Potential changes to the program are already garnering praise from healthcare associations across the industry.

The American Medical Association (AMA) released a public statement praising the federal organization’s motion to offer physicians increased flexibility through these proposed changes. 

“CMS is proposing a number of policies to help physicians avoid penalties under the Quality Payment Program,” said AMA President David O. Barbe. “In particular, it is suggesting several actions to assist small practices. The Administration showed it heard the concerns raised by the AMA on behalf of practicing physicians.”

The American Academy of Family Physicians (AAFP) also submitted a letter to Administrator Seema Verma seeking changes to QPP to reduce administrative strain on physicians.

“Not all physicians and their practices were ready to make the leap, and many faced daunting challenges,” Barbe explained. “This flexible approach will give physicians more options to participate in MACRA and takes into consideration the diversity of medical practices throughout the country.”

The American Medical Informatics Association (AMIA) commended the new proposed rule for its potential to reward clinicians helping to modernize healthcare delivery.

“While there are numerous details to review, AMIA is pleased that CMS has proposed a flexible set of requirements meant to encourage health IT-enabled care,” said AMIA President Douglas B. Fridsma, MD. “Specifically, the proposal to reward those clinicians who demonstrate more advanced use of health IT to support patient care through 2015 Edition CEHRT will improve interoperability for providers and provide patients with better access to their data.”

AMIA also applauded potential changes offering clinicians additional time to upgrade or adopt 2015 Edition CEHRT through another 90-day reporting period. The option to utilize legacy versions of CEHRT in the coming year was also an important proposal, AMIA said.

CMS also intends to expand the list of Improvement Activities eligible to count as bonus payments for the MIPS Advancing Care Information performance category.

“This approach helps credit clinicians for using health IT within a care improvement context, and we see this as a more outcomes-focused approach to measuring health IT use,” said Fridsma. “We look forward to looking into the rule in more detail and providing our feedback.”

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