CMS makes first move to see if MACRA will save money

Modern Healthcare - - LATE NEWS - —Vir­gil Dick­son

The CMS is tak­ing its first steps to see whether MACRA will lead to re­duced Medi­care spend­ing with a new pi­lot.

The test will eval­u­ate eight new mea­sures to de­ter­mine if physi­cians in the Merit-based In­cen­tive Pay­ment Sys­tem, known as MIPS, are ac­tu­ally re­duc­ing the cost of care. The CMS un­veiled the ini­tia­tive just two weeks af­ter the Medi­care Pay­ment Ad­vi­sory Com­mis­sion sug­gested re­peal­ing MIPS over con­cerns it wouldn’t lead to bet­ter qual­ity of care or lower costs.

Un­der MIPS, providers be­come el­i­gi­ble for ei­ther bonus pay­ments or penal­ties based on their per­for­mance.

Two years af­ter the law’s roll­out, the CMS still hasn’t out­lined ex­actly how providers will be judged un­der the cost met­ric as the agency con­tin­ues to de­velop spe­cific mea­sures to see if doc­tors are re­duc­ing spend­ing.

The new CMS pi­lot will track cost data for eight pro­ce­dures and med­i­cal con­di­tions. As part of the ex­per­i­ment, the CMS has cre­ated re­ports for around 17,000 med­i­cal prac­tices.

Acu­men, a re­search firm hired by the CMS, is reach­ing out to the physi­cian groups to re­view their re­ports and com­plete a sur­vey on if the data pro­vided is ac­cu­rate. Clin­i­cian feed­back will be used to re­fine the mea­sures prior to their use in MIPS. Prac­tices have un­til Nov. 15 to com­ment.

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