Andy Slavitt calls for 'meaningful engagement' on MACRA proposal as public comment period kicks off
Acting Centers for Medicare and Medicaid Services chief tells providers that new payment rules are still in their early stages.
The implementation of MACRA and the introduction of the Quality Payment Program is "flexible common-sense approach" for paying physicians, acting Centers for Medicare and Medicaid Services chief Andy Slavitt said at the American Hospital Association's annual membership meeting this week, though the government is actively seeking feedback on the new program.
Slavitt called for "meaningful engagement" on the proposal that replaces meaningful use. Public comment is open for 60 days, with Slavitt and team expected to conduct several listening and education sessions to gather feedback on the proposal.
"I offer one editorial comment on new payment models. We should all take a step back and recognize that all of them are at early stages," Slavitt said. "I compare them to the first and second generation iPhones, still getting their first use and allowing us to see what works and what doesn't. We should – however – expect these models to get better and better with every release."
[Also: CMS finalizes quality measures in support of MACRA]
In his comments, Slavitt also set forth what he called an "aggressive agenda" regarding simplification for physicians, rural health, and interoperability. He said the regulatory burden placed on physicians needs to be reduced such that they can spend more time with patients, but acknowledged CMS has barely scratched the service with its efforts so far.
"The work we've done recently over the two-midnight policy and the Recovery Audit Contractor program reflects the result of paying attention to significant feedback and is intended to create more discretion for care providers and move the RAC program from a 'gotcha' feeling to a more educational and partner-oriented approach using Quality Improvement Organizations," he said. "And we are in conversations now about finding opportunities to find ways to extend the simplifications of Advancing Care Information, the successor to meaningful use, into the hospital setting."
CMS recently announced a rural health task force that will focus on addressing the economic realities of health care in the country's many rural communities, issues with access to care and innovation/technology. He said that work will continue.
[Also: Breaking down the Medicare physician payment changes for doctors under MACRA]
"That task force has hit the ground running and we have dedicated payment models, technical assistance funds, and provisions set up to specifically assist rural hospitals and other care providers," Slavitt said.
Slavitt also called electronic health record interoperability a priority at the highest level of government. He drew a firm line for the industry, saying that any business model that limited the flow of data or failed to center on the patient must be done away with, and the industry should only embrace vendors and contractors that ban practices that inhibit the safe flow of data which patient care demands.
"Together, we have made significant investments in new technology, but they will only be fully realized if health IT becomes a connected platform for collaboration and innovation," Slavitt said.
As for the consumer market, Slavitt said people want affordable healthcare and that demand is driving trends on insurance exchanges. He said 70 percent of insurance exchange consumers changed plans during open enrollment, saving $500 a year by moving to hospitals and plans that partnered for lower overall costs.
He also pointed out that "millions of times over," consumers did not shop for a health plan, but rather selected a hospital, doctor or prescription they wanted, then found a health plan that offered it.
[Also: MACRA rules for physician payments stacked against small practices, critics say]
Slavitt also said that for providers, exchange customers are valuable commodities because most are previously uninsured people who are now armed with coverage and looking to build new, potentially long-lasting relationships with doctors and hospitals for the good of their families.
"Ultimately, consumers will reward those who want their business and have an affordable strategy to get it," Slavitt said.
Twitter: @BethJSanborn
