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October 13, 2016 01:00 AM

CMS seeks to ease MACRA rollout by reducing physicians' administrative burdens

Shelby Livingston
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    The CMS on Thursday announced a long-term initiative to improve physicians' experience with the Medicare program by reducing administrative burdens.

    The initiative seeks to increase physician engagement and improve physician experience with Medicare by reviewing regulations and policies to minimize administrative tasks as the CMS gets set to drop its final rule on the Medicare Access and CHIP Reauthorization Act of 2015, or MACRA.

    Physician reporting for MACRA—Medicare's new physician payment incentive program—is set to begin in January, though many physician advocacy groups have said doctors aren't ready. Health system leaders have said the reporting requirements are more burdensome than those under previous incentive programs. The CMS will release the final rule on MACRA by Nov. 1, and some expect the rule to drop this week.

    “As we implement the Quality Payment Program under MACRA, we cannot do it without making a sustained, long-term commitment to take a holistic view on the demands on the physician and clinician workforce,” Acting CMS Administrator Andy Slavitt said in the statement. “The new initiative will launch a nationwide effort to work with the clinician community to improve Medicare regulations, policies, and interaction points to address issues and to help get physicians back to the most important thing they do – taking care of patients.”

    To start, the CMS is launching an 18-month pilot program to reduce medical review for certain physicians. Providers in advanced alternative payment models will be “relieved of some scrutiny under certain medical review programs,” the CMS said in the announcement.

    The initiative will be led by senior physicians within the CMS who will report to the Office of the Administrator, the CMS said. Slavitt appointed Dr. Shantanu Agrawal, the deputy administrator for program integrity and director of the Center for Program Integrity at the CMS, to lead the initiative.

    In a statement Thursday, American Medical Association President Dr. Andrew Gurman said the news is “a notable first step in the agency's new effort to lessen the regulatory burden for physicians.” The AMA, along with other advocacy groups, has been urging the administration to ease burdensome administrative requirements imposed on physicians.

    The CMS Thursday also said that each of the 10 CMS regional offices will oversee local meetings to take input from physician practices within the next six months. Regular meetings will also be held to ensure the CMS is hearing from physicians on the ground.

    To avoid penalties under MACRA, physicians will participate in one of two reimbursement tracks: a merit-based incentive payment system, known as MIPS, or advanced alternative payment models. Most physicians are expected to choose the MIPS route because they are not ready to take on the financial risk associated with alternative payment models. Just a few large groups plan to accept payment adjustments under existing alternative payment models, like accountable care organizations and medical homes.

    After the pilot, the CMS will consider expanding the initiative to additional advanced alternative payment models, specialties and provider types, the agency said.

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