On June 20, the Centers for Medicare & Medicaid Services (CMS) issued a proposed rule that would alter the Quality Payment Program (the new Medicare value-based reimbursement system) as required by the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA). CMS hopes the proposed rule will simplify the Quality Payment Program, especially for small, independent, rural practices, while also ensuring fiscal sustainability and high-quality care within Medicare.
The program, established under MACRA, began in 2017 with the objective of improving health outcomes, implementing fiscal responsibility, minimizing the burden of participation, and offering fair and transparent guidelines. The program significantly changes how clinicians are paid within Medicare; the program ended the sustainable growth rate formula and allows health care providers to access tools, models and resources to aid in patient care. Physicians can choose how they want to participate in the program based on their practice size, specialty, location or patient population. The proposed rule would amend some existing requirements and it also contains new policies that would encourage participation in either advanced alternative payment models (APMs) or the merit-based incentive payment system (MIPS).
