AAFP Urges CMS to Simplify MACRA-Implementation Regulations

Friday, June 24, 2016

Leslie Champlin
Senior Public Relations Strategist
American Academy of Family Physicians
(800) 274-2237, Ext. 6252

LEAWOOD, Kan. — Despite support of the Medicare Access and CHIP Reauthorization Act, which revamps Medicare physician payment, the American Academy of Family Physicians today urged the Centers for Medicare & Medicaid Services to make multiple changes to strengthen and improve proposed regulations implementing the law.

“The AAFP continues to support MACRA,” Robert Wergin, MD, chair of the AAFP Board of Directors, wrote in a letter responding to CMS proposed rules implementing the law. “We believe it was intended to strengthen primary care and make primary care a strong foundation for payment and delivery reform for physician services under Medicare. As such, the importance of successful implementation for members practicing in communities across the country cannot be understated.

“That said, we must strongly state that we see a need and opportunity for CMS to step back and reconsider their approach to this proposed rule which we view as overly complex and burdensome to our members and indeed for all physicians. The implementation of MACRA will impact our health care system for years to come, and it must be done thoughtfully, carefully and as simply as possible -- and this proposed rule at present falls short of these goals.”

Wergin outlined multiple suggestions for reducing the complexity, cutting the administrative requirements, establishing appropriate quality measures and expanding on progress of increasing patient access to patient-centered medical homes. Among them:

Delay the initial measurement period for determining subsequent payment. Under no circumstances should the initial performance period start earlier than July 1, 2017. Physicians need more than two months from the final rule’s anticipated November release to prepare for participation.

Require all physician specialties to meet the same program expectations. The AAFP strongly calls for specialists and sub-specialists to be required to meet the same MIPS program expectations. Parity in reporting across all physician groups is critically important.

Use the core measure sets developed by the multi-stakeholder Core Quality Measures Collaborative. All measures used in MIPS and APMs must be clinically relevant, harmonized and aligned among all public and private payers, and minimally burdensome to report. The AAFP recommends that CMS use the core measure sets developed by the multi-stakeholder Core Quality Measures Collaborative to ensure alignment, harmonization and the avoidance of competing quality measures among payers.

Simplify the Advancing Care Information. The AAFP believes the current proposal for the ACI has missed the mark in a major way and demands reconsideration. Although ACI improves on the requirements of the meaningful use program, the burden of compliance still outweighs the benefit that patients will experience. CMS should significantly improve and reduce administrative complexity and burden while complying with current law.

Use established guidelines and principles to determine if a patient-centered medical home qualifies as an advanced alternative payment model. The AAFP urged CMS to:

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Founded in 1947, the American Academy of Family Physicians represents 134,600 physicians and medical students nationwide, and it is the only medical society devoted solely to primary care.

Family physicians conduct approximately one in five of the total medical office visits in the United States per year – more than any other specialty. Family physicians provide comprehensive, evidence-based, and cost-effective care dedicated to improving the health of patients, families and communities. Family medicine’s cornerstone is an ongoing and personal patient-physician relationship where the family physician serves as the hub of each patient’s integrated care team. More Americans depend on family physicians than on any other medical specialty.

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