CMS seeks to ease burdens for quality program

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Seema Verma
Seema Verma


Small and rural providers may find it easier to participate in quality programs under the Medicare Access and CHIP Reauthorization Act (MACRA) following a proposed rule that the Centers for Medicare & Medicaid Services issued Tuesday.

The Quality Payment Program is updated annually. Clinicians can choose how they want to participate based on their practice size, specialty, location or patient population. CMS said it wanted to ensure “meaningful measurement” and support a pathway to participation in Advanced Alternative Payment Models, along with improving coordination of care for patients.

“We've heard the concerns that too many quality programs, technology requirements and measures get between the doctor and the patient,” said CMS Administrator Seema Verma. “That's why we're taking a hard look at reducing burdens. By proposing this rule, we aim to improve Medicare by helping doctors and clinicians concentrate on caring for their patients rather than filling out paperwork. CMS will continue to listen and take actionable steps towards alleviating burdens and improving health outcomes for all Americans that we serve.”

In the proposed rule, CMS seeks to extend the revenue-based nominal amount standard, which was previously finalized through performance year 2018, for two additional years. This allows a system in an alternative payment model to move up to an Advanced APM if participants are required to bear total risk of at least 8% of their Medicare Parts A and B revenue.

Another change proposed for fiscal 2018 would be to add bonus points for complex patients. CMS is asking for comments on the option of including dual eligibility as a method to adjust scores, as an alternative or in addition to the the Hierarchical Conditions Category risk score.

Comments are due August 18. When commenting, refer to file code CMS 5522-P.