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.”
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