CMS promises more APM's, continued flexibility, better alignment of reporting tracks for MACRA

CMS is eyeing certain changes that could help align quality reporting measures for physicians and hospitals as well as drive more eligible clinicians toward the advanced payment model track of MACRA, a report from HFMA said.

The reporting tracks for hospitals and physicians are separate and it's been a bone of contention from the beginning of the MACRA evolution, hindering quality reporting for the law's first two years, according to Kate Goodrich, director of the Center for Clinical Standards and Quality and CMO for the Centers for Medicare and Medicaid Services.

The goal of facility-based scoring, by contrast, could help physicians who want to use their hospital's quality-measure performance for reporting under MACRA's merit-based Incentive payment system. This method is part of CMSs effort to lessen regulatory burdens.

"This gets to an alignment of incentives between hospitals and the clinicians who work in those hospitals in terms of what they are focused on for improvement and ultimately for accountability," Goodrich said Tuesday at a meeting in Washington, D.C.

Goodrich also said moving more physicians into APMs is a "top strategic goal" for CMS. The bundled payments for care improvement advanced program is the latest push toward an APM from CMS. The program will qualify as an APM under MACRA starting next year.

The Bipartisan Budget Act also included provisions for MIPS including the removal of Medicare Part B drug costs as factor in MIPS payment adjustments as well as low-volume threshold determination. Coming at the end of March, there will be updates as to what physicians will be required to participate in MIPS and later updates on which physicians will qualify as APM participants, the report said. CMS plans to unveil a multi-payer APM under MACRA that will take effect in 2019. 

Since the BBA gave CMS three more years to continue to roll out MACRA, it will be able to keep the scoring and weight of the MIPS cost category low as well as preserving flexibility in performance benchmark setting that will keep providers from incurring penalties.

"We continue to hear that the program is still too complicated," Goodrich told HFMA. "People are glad we've allowed for a lot of flexibilities, but what that does is makes things complicated. We've gotten some very specific ideas about ways we can further simplify the scoring in some of the policies."

Twitter: @BethJSanborn
Email the writer: beth.sanborn@himssmedia.com