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Tuesday May 10, 2016

MACRA is Coming, the AAFP Has Resources to Help

A little more than a year ago, Congress approved the Medicare Access and CHIP Reauthorization Act (MACRA) by substantial bipartisan votes of 392-37 in the House and 92-8 in the Senate.  

To put these votes in context, 91 percent of Congress voted to repeal the flawed sustainable growth rate (SGR) formula and put our nation’s health care system on a new trajectory. On April 16, 2015, President Obama enacted this historic legislation into law. With a single stroke of the pen, the entire construct of how physicians are paid for their services, changed.

During the past 11 months, the AAFP has been diligently reviewing and analyzing MACRA in an effort to better understand the law so that we can prepare and position you for success. In addition, we initiated programs aimed at educating family physicians about the changes that are coming with respect to delivery system and payment reforms.  

We launched a resource center and published content designed to assist you in understanding the scope and implications of the law. My colleague Amy Mullins, M.D., wrote a great primer for Family Practice Management entitled "Making Sense of MACRA."

I addressed the two payment pathways established by MACRA -- the Merit Based Incentive Payment System (MIPS) and the Alternative Payment Models (APMS) in previous posts on this blog. These resources were appropriate and adequate for the early stages of our member education campaign, but we promised you we would do more for you, our members.  

Last Friday, we took the first step towards fulfilling that promise by ramping up our efforts in a big, big way through the announcement of MACRA Ready, which is a multi-faceted, multi-year campaign aimed at preparing our members for the new delivery reforms and payment pathways created by the law. The campaign features educational content on how the law is structured and functions, timelines for implementation, and tools aimed at helping you and your practice understand and prepare for one of the two payment pathways.  

The most common question I am asked these days goes like this, "What should I be doing to prepare myself and my practice for MACRA?" I encourage you to visit the AAFP’s MACRA resources page. Here you will find information, tools and resources that are designed to help you better understand the new law. I have selected a few resources that will provide a good starting point:

The AAFP has also produced a series of MACRA webinars. This four-part series provides you with:

  • an overview of MACRA;
  • an introduction to MIPS;
  • an introduction to APMs; and
  • information about your current payment track.

I encourage you to sign up to receive MACRA email updates from the AAFP. These periodic emails will provide you the latest details on the new payment law and access to the latest tools and resources from the AAFP.

During the past year, I have had the opportunity to discuss MACRA with thousands of family physicians across the country. It is fair to say that many are anxious about these changes and eager to learn what the new law will mean to them and their practice. This is completely understandable. I firmly believe that the SGR was one of the worst health care policies every enacted into law and that family physicians and our health care system are far better off since it has been sent to the garbage pile of failed policies. However, I do understand that the SGR and the traditional fee-for-service system were familiar and, no matter how bad they were, you knew and understood them.  

I often refer to MACRA as a historic law. Besides the fact that it repealed a severely flawed payment formula, MACRA made a substantive and meaningful shift in the ideology of the Medicare physician payment formula by shifting the concept of payment from payment for episodes of care to payment for the longitudinal quality of care provided to patients. Most importantly, the new law took significant steps to place an expressed emphasis on the importance of primary care.  

Although there has long been an academic and conceptual belief that a health care system built on a primary care foundation is beneficial to patients and payers, there had never been a policy manifestation of this ideology -- until now. This law, by design and intent, places a renewed emphasis on primary care delivery models and goes so far as to protect them from financial risk in the APM pathway.  

This renewed approach to primary care was set in motion as part of MACRA, but it can only be achieved as a result of the regulations issued by CMS. Therefore, the approach taken by CMS to implement MACRA is key. On May 5, CMS Acting Administrator Andy Slavitt tweeted some information, and I think you will be pleasantly surprised by what he had to say:

  • "Must start with a core belief that MDs know best how to take care of patients and allow freedom"
  • "Must simplify the practice of medicine: reduce burden, add flexibility, and provide support at every turn"
  • "Pay more to PC [primary care] for care coordination, for dialogue, for cost of care outcomes"

I respect that some of you will disagree that MACRA holds any opportunity or value, and I look forward to hearing your thoughts, concerns, and suggestions. I can promise you this, the AAFP will do everything we can to provide you information, resources and tools that will allow you to be successful under one of the two new payment pathways.

Posted at 07:00AM May 10, 2016 by Shawn Martin

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ABOUT THE AUTHOR



Shawn Martin, AAFP Senior Vice President of Advocacy, Practice Advancement and Policy.

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The opinions and views expressed here are those of the authors and do not necessarily represent or reflect the opinions and views of the American Academy of Family Physicians. This blog is not intended to provide medical, financial, or legal advice. All comments are moderated and will be removed if they violate our Terms of Use.