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Is MACRA the “Burning Platform for Progress” in Healthcare?

The head of CMS views MACRA and its implementation as the means of making value-based care a reality across the United States.

By Kyle Murphy, PhD

According to the Acting Administrator of CMS, MACRA is the vehicle for realizing progress in care delivery by aligning the quality goals of both federal regulators and individual physicians.

"When we put our minds to it, I have seen how much technology can radically improve health care and how fast. MACRA is the burning platform for progress in care delivery, just as the ACA was in health care coverage. Together, we can make the system radically better," Andy Slavitt told attendees at Health Datapalooza, which ends today.

Slavitt's comments were republished on the official CMS blog.

In drawing comparisons between the technology used to implement the Affordable Care Act versus that used to implement the Medicare Access and CHIP Reauthorization Act, Slavitt noted that the latter is lagging behind.

"Like the major change we went through as we improved access to coverage, we are now on the cusp of an equally transformative change in quality and affordability — paying physicians and hospitals for providing the right care," argued Slavitt. "Yet now, while technology supports us in getting coverage, it is failing us in the care experience."

The CMS chief claimed that the present offers the greatest opportunity for healthcare and health IT innovators to flourish and "change the course of history" if they approach technology appropriately:

For all of these macro changes, very little technology has yet to be created to make this change work. In short, it’s the perfect time to be an innovator. You can help change the course of history. We must learn how to take care of people better in their own homes and communities. We need to empower physicians so that technology improves their morale, not saps it. An entirely new operating system for health care will be needed to support it.

In working to advance value-based care delivery under MACRA, Slavitt emphasized the importance of looking to leading edge physicians working in forms of accountable care for insight. One such insight is giving providers what they need most — tools for collaborating with other providers.

"The purpose of new payment models is to give care providers the freedom to do what they think is right. Your opportunity is to allow it to happen. Go find them and talk to them– design for them," he stated.

While at the same time motivating innovators in healthcare, Slavitt issued an ultimatum to the industry as a whole — to lead, follow, or get out of the way:

If you want to lead the way with innovations that help consumers, great.

If you want to follow by using established standards for data and measurement and technology, also great.

If you have a business model which relies on silo-ing data, not using standards, or not allowing data to follow the needs of patients, pick a new business model or pick a new business. What Vice President Biden said should stick with us– as taxpayers, we did not spend $35 billion so companies could build their own silos.

Slavitt drove home the point that the efficient flow of information throughout healthcare is essential to the transition from volume to value. In particular, he called out contracts that limited plug-and-play functionality while promoting more robust provider-patient communication tools and application programming interfaces (APIs) for unlocking EHR data.

"Without better connected and easier to use technology, I worry most about the people with the least access to care," he admitted. "I worry about the independent physician practice. I worry about our country’s Cancer Moonshot. But mostly I worry that the moral underpinnings of our public-private health care system won’t support where we need to go."

Unless these challenges are mitigated, the healthcare industry is likely to miss out on the opportunity to implement value-based care and improve patient outcomes for both individuals and populations.

And that will mean our chances of any meaningful success will be held up, not because we can’t do it, but because we won’t do it.

Given the number of appearances Slavitt has made recently, CMS is on a campaign to ensure that MACRA implementation does not become a squandered opportunity for widespread healthcare reform.

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