What You Said About MACRA…

Just a few weeks ago, the Department of Health & Human Services dropped the finalized Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) rule – a landmark new payment system moving health care to a merit-based payment system. The rule, weighing in at almost 2,400 pages, has garnered more than 4,000 public comments since its proposal in April, is scheduled to become effective Jan. 1, 2017. With so little time to prepare, we asked some of Alabama’s physicians what they think about MACRA.

“MACRA is a very complex law and will be a burden for many of our physicians. However, please remember that MACRA repealed and replaced the SGR, the flawed program where we all annually faced pay cuts of 20 percent and greater and were always at the mercy of Congress to provide relief that almost always came at the last minute. With MACRA, we have the stability of knowing what to expect, we have the potential of increased payments and even bonus payments along with the possibility of negative updates as well. If you participate in Pick-Your-Pace at any level of participation in 2017, you will avoid any potential penalties in 2019, the first year of MACRA implementation. The MACRA updates in 2019 start at +/- as much as 4 percent and go up slowly each year but come nowhere close to the 21 percent cuts we faced under SGR. MACRA is by no means perfect, but it does begin the Medicare transition from volume-based Fee-For-Service payments to a value-based payment system. I would encourage all physicians to participate in Pick Your Pace at whatever level you are able to accomplish in 2017 to avoid potential penalties in 2019. As we delve deeper into this law, stay tuned for future updates and recommendations.” – John Meigs Jr., M.D., Brent

“Because I see very little Medicare patients, I have not studied MACRA or MIPS other than to know it will be a burden to physicians and staff in time or expense to hire a third party to do the reporting requirements. For physicians like me that see little Medicare patients, but just enough (about 100 a year) to be required to do the reporting to be penalized, it is burdensome. I may take the penalty and then ultimately not see Medicare anymore because it isn’t cost efficient for my practice. The government is continually putting more costly regulations and requirements on physician practices pressuring the overall viability of a private practicing physician in the future. There will come a breaking point.” – McCain Ashurst, M.D., Montgomery

“They’re talking about a reduction in payments for failing to meet standards, but how do you assess that — what metric do you use? How do you assess quality? And there’s a lot of flippant interpretations of what they’ll pay.” – Clifford Black, M.D., Anniston, quoted in The Anniston Star

“We’ll just have to pay more attention to what we do … how often patients get treatment … show that patients are getting proper quality of care … if you do it enough it’ll eventually become second nature. But it is a slightly greater bureaucratic level on physicians. Generally, the quality of care is good right now … maybe there will be a 1 to 2 percent improvement.” – Todd Scarbrough, M.D., Anniston, quoted in The Anniston Star