CMS Launches Initiative to Reduce MACRA Administrative Demands

CMS Launches Initiative to Reduce MACRA Administrative Demands

On Oct. 13, the Centers for Medicare & Medicaid Services (CMS) announced its effort to relieve some of the administrative burdens of Advanced Alternative Payment Models (APMs) on physicians. While implementing new healthcare delivery system reforms stemmed from the Affordable Care Act and the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA), CMS wants clinicians to be satisfied with MACRA quality-based payment programs and to ensure demands won’t be too much. That way, physicians can remain focused on what’s important: patient care.

Lead Developer Shantanu Agrawal, MD, said, “CMS is turning a new page in assessing not only how to reward for quality, but also to reduce administrative hurdles.”

Certified Hematology and Oncology Coder CHONC

The First Initiative Begins a Pilot Program

For the first initiative, Medical Review Reduction, CMS will:

  • Launch an 18-month pilot program that reduces medical review for certain physicians while still protecting program integrity.
  • Allow providers practicing within specified APMs to be relieved of some scrutiny under specific medical review programs.
  • Consider expanding and adding Advanced APMs, specialties, and provider types, after analyzing the pilot program’s results.

The pilot is comprised of two phases. Phase 1 (post-payment reviews conducted), which will be from Jan. 1, 2017 – June 1, 2018 and Phase 2 (pre-payment reviews conducted), which will be from April, 1, 2017 – June 1, 2018.

The Advanced APMs that will be included in the pilot are:

  • Next Generation Accountable Care Organizations (ACOs)
  • Medicare Shared Savings Program track 2 and 3 participants
  • Pioneer ACOs
  • Oncology Care Model 2-sided track participants

For more information, please review the CMS Fact Sheet and the Medicare Fee-for-Service Compliance Programs Web page.

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Michelle Dick
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Michelle Dick

Executive Editor at AAPC
Michelle A. Dick has been executive editor for AAPC for over seven years. Prior to her work at AAPC, she was editor-in-chief at Eli Research and Element K Journals, and disk ad coordinator, web designer/developer, and graphic artist at White Directory Publishers, Inc. Dick has a Bachelor of Science in Graphic Design from the State University of New York - Buffalo State and is a member of the Flower City Professional Coders in Rochester, N.Y.
Michelle Dick
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About Has 134 Posts

Michelle A. Dick has been executive editor for AAPC for over seven years. Prior to her work at AAPC, she was editor-in-chief at Eli Research and Element K Journals, and disk ad coordinator, web designer/developer, and graphic artist at White Directory Publishers, Inc. Dick has a Bachelor of Science in Graphic Design from the State University of New York - Buffalo State and is a member of the Flower City Professional Coders in Rochester, N.Y.

One Response to “CMS Launches Initiative to Reduce MACRA Administrative Demands”

  1. Karl Ellzey says:

    It doesn’t seem that this will help solo practitioners or small groups. Those aren’t the ones upset about the MACRA reporting requirements the MOST. MACRA/MPIS is TOO much reporting and not enough time spent seeing patients.

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