- Thousands of people have shared their thoughts with the CMS regarding the initial proposal for MACRA, including 4,000 who submitted formal comments and more than 64,000 who attended outreach sessions, CMS Acting Administrator Andy Slavitt told the American Osteopathic Association during his address at their annual business meeting.
- Slavitt described CMS' interaction with providers as resulting in record levels of engagement that he said are grounding the administration's priorities and providing "hard, but important truths."
- Promoting MACRA and the degree to which it comes from providers themselves comes in the run-up to the final version due later this year, and the implementation slated (though not certain) for 2017.
The comments serve efforts to drum up buy-in and enthusiasm for MACRA given that it's coming soon and has drawn significant concern. According to a recent Deloitte survey, only about 50% of practicing physicians have even heard of the law and eight in 10 physicians said they still preferred traditional fee-for-service payment or salary for their compensation.
Slavitt aimed to demonstrate at last week's meeting how providers' feedback is being used to ensure MACRA will not just make things better in terms of costs and patient care, but in solving some of physicians' problems that are currently leading to burnout.
He suggested it will improve complaints regarding overwhelming paperwork; measures that become exercises in compliance rather than quality improvement; technology requirements that distract from patient care; and a concern that those at CMS "don’t get it."
"This gives us all a place to start thinking about a new framework and the drive to develop a roadmap that not only improves patient care, but does it by beginning to address some of the very real causes of physician burnout," Slavitt said.
He detailed how providers' feedback falls into five priority areas for the CMS:
- Impact on patients, including keeping the focus on patient care;
- Simplified reporting and feedback, including putting the burden on technology rather than the user to adapt to workflow;
- Impact on small and rural practices, including providing a level playing field by ensuring MACRA is not too "administratively burdensome" and deploying technical assistance;
- Pathway for Advanced Alternative Payment Models, which notes that a one-size-fits-all program won't work, necessitating multiple pathways to models that qualify for Advanced APMs that pay a 5% bonus for participation; and
- Physician readiness for new program, which ensures physicians are prepared for the coming changes and are "set up for success."
The final rule is set to be released by November 1.