CMS Acting Director Slavitt Says MACRA Might See Delayed Implementation

By Christine Kern, contributing writer

Testifying before the Senate Finance Committee, Slavitt admits start date could be pushed back.

In a Senate Finance Committee hearing discussing CMS’ implementation of the Medicare Access and CHIP Reauthorization Act (MACRA), Acting CMS Administrator Andy Slavitt testified the agency might delay implementation of the MACRA payments beyond its scheduled January 1, 2017 date, according to Modern Healthcare.

Slavitt explained, “The enactment of MACRA, which replaced the Sustainable Growth Rate (SGR) formula with a more consistent way for paying physicians and other clinicians, provided new tools to modernize Medicare and simplify quality programs and payments for these professionals. Currently, Medicare measures the value and quality of care provided by physicians and other clinicians through a patchwork of programs.”

These include some 30 percent of Medicare payments that are tied to alternative payment methods (APMs.), and Slavitt asserted hospital and physician participation in APMs is a “major milestone in the continued effort towards improving quality and care coordination.” The CMS aims to tie 50 percent of traditional Medicare payments to APMs by 2018, especially in light of MACRA.

Slavitt testified CMS has carefully listened to stakeholder comments regarding the proposed rule and the agency is concerned that some physicians, particularly those in small practices, may not be prepared for the changes under MACRA by January 1. In additional to alternative start dates, Slavitt said the agency is also considering shorter reporting periods and/or allowing doctors to familiarize themselves with new methods before the “impact really hits them,” explaining, “The focus on small independent practices and their ability to continue to practicing independently is a very important priority for us.”

Ultimately, CMS is further encouraging alternative payment models like bundling, medical homes, and team-based and prevention models. He testified, “We need to get out of the mode of paying physicians just to run tests and prescribe medicines.”

Slavitt said, “For [MACRA] to be successful —in other words, for MACRA to improve care delivery and lower healthcare costs — we must first demonstrate to clinicians and patients both the value of these new payment programs established by MACRA and the opportunity for these participates to shape the healthcare system of the future. The program must be flexible, practice-driven, and person-centered. It must contain achievable measures; it must support continued and improved information sharing through innovations and advancements in interoperability and the health IT infrastructure; it must engage and educate physicians and other clinicians; and it must promote and reward improvement over time.”