[{"innerBlocks":[],"name":"core\/freeform","postId":946,"blockType":{"name":"core\/freeform","keywords":[],"attributes":{"content":{"type":"string","source":"raw"},"lock":{"type":"object"}},"providesContext":[],"usesContext":[],"selectors":[],"supports":{"className":false,"customClassName":false,"reusable":false},"styles":[],"variations":[],"apiVersion":3,"title":"Classic","description":"Use the classic WordPress editor.","category":"text"},"originalContent":"While doctors are generally supportive of payment reform goals under the Medicare Access and CHIP Reauthorization Act, they are concerned that MACRA\u2019s quality measures\u2014designed to reward value\u2014are missing the mark.

That\u2019s the consensus of physician groups that testified on Wednesday before a Senate committee hearing on the implementation of MACRA by the Centers for Medicare and Medicaid Services.

The American College of Surgeons \u201csupports MACRA\u2019s focus on quality and value,\u201d said Frank Opelka, MD, medical director for quality and health policy at ACS. However, he told the committee that \u201ca hurried CMS implementation has resulted in quality metrics that left surgical care as an afterthought.\u201d

Opelka charged that CMS has relied on \u201ctheir skills as a payer to retrofit a tired fee-for-service payment model with sporadic measures, which do not make sense to the surgical care teams and outcomes patients seek.\u201d

MACRA offers clinicians two Quality Payment Program tracks to choose from: the Merit-Based Incentive Payment System (MIPS) or the Advanced Alternate Payment Models (APMs).

Opelka contended that, for many physicians, MIPS \u201chas not and\u2014given its current trajectory\u2014will not serve as a driver of improvement in quality or reduction of cost.\u201d

Likewise, John Cullen, MD, president of the American Academy of Family Physicians, testified that MIPS \u201chas created a burdensome and extremely complex program that has increased practice costs and is contributing to physician burnout.\u201d Further, Cullen observed that \u201cunderstanding the requirements and scoring for each MIPS performance category and reporting data to CMS is a complex task and detracts from physicians\u2019 ability to focus on patients.\u201d

Barbara McAneny, MD, president of the American Medical Association, told the committee that the Quality Payment Program \u201cstill needs significant improvements,\u201d and AMA\u2019s physician members contend that \u201cthere is no link between many of the MIPS measures they are required to report and improving clinical care for their patients.\u201d

McAneny said that the AMA urges Congress to continue to make technical changes to MACRA to simplify the QPP to make it \u201cmore clinically significant\u201d because the measures that doctors are \u201crequired to report are taking time away from patient care.\u201d

When it comes to healthcare IT, AMA has called for updating the Promoting Interoperability performance category to enable physicians to use certified electronic health record technology in \u201cmore clinically relevant ways.\u201d

AAFP\u2019s Cullen said in his testimony that one of the more concerning parts of MIPS is the Promoting Interoperability (PI) category, which is intended to promote patient engagement and electronic exchange of information using certified EHRs.

\u201cCMS is hamstrung in PI since the agency is bound to Meaningful Use requirements by legislation, including both the American Recovery and Reinvestment Act and the Affordable Care Act,\u201d Cullen says. \u201cThe AAFP calls on Congress to repeal Meaningful Use requirements and allow HHS to remove these requirements from the PI category.\u201d

Also See<\/b>: Physician groups call for tech changes to MIPS<\/a>

While Cullen said AAFP is pleased that HHS is pursuing interoperability and stopping information blocking, the group remains \u201cextremely concerned and adamantly opposed\u201d to the \u201call or nothing\u201d approach of the PI category.

\u201cCMS should eliminate health IT utilization measures and remove any required measures, and provide eligible clinicians the flexibility to select measures relevant to their practice,\u201d added Cullen. \u201cCongress should encourage CMS to simplify the scoring, remove health IT utilization measures and the \u2018all or nothing\u2019 requirement, and hold health IT vendors accountable for interoperability before measuring physicians on EHR use.\u201d

While Cullen noted that the AAFP supports the 2015 Edition Certified EHR Technology, he noted that the group has concerns with it being mandated for eligible clinicians. \u201cWe strongly encourage CMS to not mandate 2015 Edition CEHRT, but rather incentivize its adoption through scoring, which benefits 2015 Edition CEHRT users.\u201d

Opelka from the American College of Surgeons complained about the Qualified Clinical Data Registries for MIPS, which are meant to advance improvements in quality and patient outcomes by providing actionable feedback to participating providers related to their performance on key metrics.

\u201cWe do firmly believe in registries\u2014we run seven international registries to date\u2014but putting them into the MACRA payment programs is not actually taking full advantage of how you would leverage data for better care,\u201d said Opelka, who made the case that only when registries have standardized data, aggregation, normalization and reporting from a \u201csingle source of truth\u201d are they valuable.

\u201cWhat we need is government guidance about how we actually set standards in key areas, how we define the data that enters registries, how that data is aggregated in a consistent manner so it comes in cleanly, how we can normalize and analyze that data together, and how we can represent it back out to patients and physicians as it\u2019s needed,\u201d Opelka added. \u201cRight now, it\u2019s the Wild West.\u201d","saveContent":"While doctors are generally supportive of payment reform goals under the Medicare Access and CHIP Reauthorization Act, they are concerned that MACRA\u2019s quality measures\u2014designed to reward value\u2014are missing the mark.

That\u2019s the consensus of physician groups that testified on Wednesday before a Senate committee hearing on the implementation of MACRA by the Centers for Medicare and Medicaid Services.

The American College of Surgeons \u201csupports MACRA\u2019s focus on quality and value,\u201d said Frank Opelka, MD, medical director for quality and health policy at ACS. However, he told the committee that \u201ca hurried CMS implementation has resulted in quality metrics that left surgical care as an afterthought.\u201d

Opelka charged that CMS has relied on \u201ctheir skills as a payer to retrofit a tired fee-for-service payment model with sporadic measures, which do not make sense to the surgical care teams and outcomes patients seek.\u201d

MACRA offers clinicians two Quality Payment Program tracks to choose from: the Merit-Based Incentive Payment System (MIPS) or the Advanced Alternate Payment Models (APMs).

Opelka contended that, for many physicians, MIPS \u201chas not and\u2014given its current trajectory\u2014will not serve as a driver of improvement in quality or reduction of cost.\u201d

Likewise, John Cullen, MD, president of the American Academy of Family Physicians, testified that MIPS \u201chas created a burdensome and extremely complex program that has increased practice costs and is contributing to physician burnout.\u201d Further, Cullen observed that \u201cunderstanding the requirements and scoring for each MIPS performance category and reporting data to CMS is a complex task and detracts from physicians\u2019 ability to focus on patients.\u201d

Barbara McAneny, MD, president of the American Medical Association, told the committee that the Quality Payment Program \u201cstill needs significant improvements,\u201d and AMA\u2019s physician members contend that \u201cthere is no link between many of the MIPS measures they are required to report and improving clinical care for their patients.\u201d

McAneny said that the AMA urges Congress to continue to make technical changes to MACRA to simplify the QPP to make it \u201cmore clinically significant\u201d because the measures that doctors are \u201crequired to report are taking time away from patient care.\u201d

When it comes to healthcare IT, AMA has called for updating the Promoting Interoperability performance category to enable physicians to use certified electronic health record technology in \u201cmore clinically relevant ways.\u201d

AAFP\u2019s Cullen said in his testimony that one of the more concerning parts of MIPS is the Promoting Interoperability (PI) category, which is intended to promote patient engagement and electronic exchange of information using certified EHRs.

\u201cCMS is hamstrung in PI since the agency is bound to Meaningful Use requirements by legislation, including both the American Recovery and Reinvestment Act and the Affordable Care Act,\u201d Cullen says. \u201cThe AAFP calls on Congress to repeal Meaningful Use requirements and allow HHS to remove these requirements from the PI category.\u201d

Also See<\/b>: Physician groups call for tech changes to MIPS<\/a>

While Cullen said AAFP is pleased that HHS is pursuing interoperability and stopping information blocking, the group remains \u201cextremely concerned and adamantly opposed\u201d to the \u201call or nothing\u201d approach of the PI category.

\u201cCMS should eliminate health IT utilization measures and remove any required measures, and provide eligible clinicians the flexibility to select measures relevant to their practice,\u201d added Cullen. \u201cCongress should encourage CMS to simplify the scoring, remove health IT utilization measures and the \u2018all or nothing\u2019 requirement, and hold health IT vendors accountable for interoperability before measuring physicians on EHR use.\u201d

While Cullen noted that the AAFP supports the 2015 Edition Certified EHR Technology, he noted that the group has concerns with it being mandated for eligible clinicians. \u201cWe strongly encourage CMS to not mandate 2015 Edition CEHRT, but rather incentivize its adoption through scoring, which benefits 2015 Edition CEHRT users.\u201d

Opelka from the American College of Surgeons complained about the Qualified Clinical Data Registries for MIPS, which are meant to advance improvements in quality and patient outcomes by providing actionable feedback to participating providers related to their performance on key metrics.

\u201cWe do firmly believe in registries\u2014we run seven international registries to date\u2014but putting them into the MACRA payment programs is not actually taking full advantage of how you would leverage data for better care,\u201d said Opelka, who made the case that only when registries have standardized data, aggregation, normalization and reporting from a \u201csingle source of truth\u201d are they valuable.

\u201cWhat we need is government guidance about how we actually set standards in key areas, how we define the data that enters registries, how that data is aggregated in a consistent manner so it comes in cleanly, how we can normalize and analyze that data together, and how we can represent it back out to patients and physicians as it\u2019s needed,\u201d Opelka added. \u201cRight now, it\u2019s the Wild West.\u201d","order":0,"get_parent":{},"attributes":[],"attributesType":{"content":{"type":"string","source":"raw"},"lock":{"type":"object"}},"dynamicContent":""}]

Physician groups voice frustrations with Quality Payment Program

More for you