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HHS Finalizes MACRA Rule, ASCO Applauds Focus on High-Quality Patient-Centered Care

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Today, the Department of Health & Human Services (HHS) finalized a landmark new payment system for Medicare clinicians that will continue the Administration’s progress in reforming how the health-care system pays for care. The Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) Quality Payment Program, which replaces the flawed Sustainable Growth Rate (SGR), will equip clinicians with the tools and flexibility to provide high-quality, patient-centered care. With clinicians as partners, the Administration is building a system that delivers better care, one in which clinicians work together and have a full understanding of patients’ needs; Medicare pays for what works and spends taxpayer money more wisely; and patients are in the center of their care, resulting in a healthier country.

“Today, we’re proud to put into action Congress’s bipartisan vision of a Medicare program that rewards clinicians for delivering quality care to their patients,” said HHS Secretary Sylvia M. Burwell. “Designed with input from thousands of clinicians and patients across the country, the new Quality Payment Program will strengthen our health-care system for patients, clinicians, and the American taxpayer.”

With the Affordable Care Act, America has made important strides in helping more Americans than ever afford quality health insurance and access patient-centered care. The Affordable Care Act created important tools to put individuals at the center of their own care and unlock access to health care data for patients and their clinicians. Today’s announcement builds on this progress and makes our health-care system work better for everyone. With MACRA, Congress gave HHS the tools to keep improving how we pay for care, so clinicians can focus on the quality of care they give, not the quantity of services they provide; and to keep improving the way care is delivered, by encouraging better coordination and prioritizing wellness and prevention.

“It’s time to modernize the Medicare physician payment system to be more streamlined and effective at supporting high-quality patient care. To be successful, we must put patients and clinicians at the center of the Quality Payment Program,” said Andy Slavitt, Acting Administrator of the Centers for Medicare & Medicaid Services (CMS). “A critical feature of the program will be implementing these changes at a pace and with options that clinicians choose. Today’s policies are designed to get all eligible clinicians to participate in the program, so they are set up for successful care delivery as the program matures.”

Details of the Quality Payment Program

Today’s rule is informed by a months-long listening tour with nearly 100,000 attendees and nearly 4,000 public comments. A common theme in the input HHS received was the need for flexibility, simplicity, and support for small practices. And that’s what this final policy aims to provide. First, the new payment system creates two pathways. These paths let clinicians pick the right pace for them to participate in the transition from a fee-for-service health care system to one that uses alternative payment models that reward quality of care over quantity of services. Clinicians will choose between two options:

  1. The first path gives clinicians the opportunity to be paid more for better care and investments that support patients. It reduces existing requirements, while still emphasizing and rewarding quality care. In the 1st year, it also provides a flexible performance period, so that those who are ready can dive in immediately, but those who need more time can prepare for participation later in the year.
  2. The second path helps clinicians go further by participating in organizations that get paid primarily for keeping people healthy. For example, they could be part of an Accountable Care Organization where clinicians come together to coordinate high-quality care for the patients they serve. When they get better health results and reduce costs for the care of their patients, the clinicians receive a portion of the savings.

ASCO Applauds Quality Payment Program’s Focus on High-Quality, Patient-Centered Care

ASCO President Daniel F. Hayes, MD, FASCO, FACP, issued a statement today supporting the Quality Payment Program:

ASCO applauds CMS for taking a critical step toward transitioning Medicare from volume-based reimbursement to a system that emphasizes high-quality, patient-centered care. In today’s release of the MACRA Quality Payment Program, CMS has demonstrated welcomed flexibility and choices for clinicians.

We are particularly encouraged that CMS has introduced Quality Payment Program transitional period for 2017 and has included the general oncology specialty measure set in the final rule after removing it from the proposed rule. We are also very pleased to see special considerations being given to small and rural practices, which will help ensure that care for vulnerable patients with cancer will not be disrupted during this period of transition.

ASCO commends CMS for listening and responding to the feedback it received from across the medical community, and for making substantive changes that will reduce reporting burden and facilitate transition to alternative payment models. We will closely review the details of the final rule and offer a detailed analysis of the rule for our members.

The content in this post has not been reviewed by the American Society of Clinical Oncology, Inc. (ASCO®) and does not necessarily reflect the ideas and opinions of ASCO®.


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