In an address to the MACRA MIPS/APM Summit, CMS Acting Administrator Andy Slavitt commented on MACRA implementation, describing how the agency will use it to “keep the promise of Medicare.”
In describing the formation of the Quality Payment Program, Slavitt emphasized the agency’s commitment to quality care, a commitment he expects to continue into the future.
“It’s a certainty that making our delivery system work better for patients and spend money more wisely will always be in season no matter which party is in charge,” he said. “And, while many new approaches and changes may come to bear, ultimately health is not a partisan issue.”
According to Slavitt, the agency’s goal when creating the Quality Payment Program was to alleviate reporting burden and streamline value-based care models, helping to make Medicare more efficient and increasing its longevity.
“Today, taxpayers spend over $500 billion each year for the Medicare program,” Slavitt remarked. “The question that needs to be addressed head on is how Medicare will continue to control costs in the face of a demographic boom as over 10,000 Americans enter Medicare each day, rising demand for health care’s new cures and technologies; and an epidemic of chronic disease.”
In creating MACRA implementation rules, Slavitt reportedly asked CMS policymakers to get outside of their DC offices and talk to the real people who these programs affect. Through these conversations, CMS workers determined that patients and providers need programs that facilitate quality care.
Physicians didn’t want the Quality Payment Program to be yet another check-the-box program, and patients didn’t want to carry around their health records and coordinate all of their care anymore.
Ultimately, CMS found that physicians wanted a program that would enable them to use their EHRs to support patient care.
“Our challenge isn’t about accountability or quality or costs or whatever euphemism people use,” Slavitt summarized. “It’s to recognize that the path forward isn’t through any one model or new three-letter acronym or quick fix, but by addressing the basic things, which lead to bad outcomes, physician burnout, or for patients, particularly needier ones, to feel displaced and not get the right care.”
CMS worked toward that goal by removing regulations and easing reporting burden for providers.
“By adopting the idea that if we simplified and reduced what was measured and gave physicians back more time with patients and instead supported their quality efforts, we would make more progress,” Slavitt explained. “And, we reduced the number of requirements in half to help level the playing field for small or independent practices.”
Additionally, the agency implemented the pick your own pace policies, which allow eligible clinicians to select the pace at which they participate in the Quality Payment Program during its first year.
Last, CMS created opportunities for technologically advanced organizations to continue to grow through Advanced Alternative Payment Models, in which the agency expects 25 percent of eligible clinicians to participate by 2018.
Working within this structure, Slavitt says the healthcare industry, spearheaded by CMS, needs to focus on making data exchange more available.
“MACRA is an opportunity to move the focus away from paperwork and reporting and towards paying for what works,” he concluded. “For a variety of reasons, EHRs became an industry before they became a useful tool. The technology community must be held accountable by their customers and make room for new innovators and to give clinicians more freedom and more flexibility to focus on their patients, to practice medicine, and deliver better care.”