More About MACRA


General MACRA Info

CMS Launches User-friendly QPP Website

The Centers for Medicare and Medicaid (CMS) have launched a user-friendly website dedicated to helping stakeholders understand the Quality Payment Program (QPP). It features detailed information about Merit Based Incentive Payment Systems (MIPS) and Alternative Payment Models (APMs), as well as data and quality reporting guidelines. You can check it out here https://qpp.cms.gov/.

QPP MIPS MACRA

CMS Releases API for Data Sharing with the Medicare Quality Payment Program

The Centers for Medicare & Medicaid Services (CMS) has released a tool, commonly referred to as an Application Program Interface (API), which allows clinicians to share electronic data with the Medicare Quality Payment Program. This release is the first in a series that will be part of CMS’s ongoing efforts to spur the creation of innovative, customizable tools to reduce burden for clinicians, while also supporting high-quality care for patients. The new API tool builds on that site by making it easier for other organizations to retrieve and maintain the Quality Payment Program’s measures and enable them to build applications for clinicians and their practices. The API, available here qpp.cms.gov/education, will allow developers to write software using the information described on the Explore Measures section of QPP.cms.gov. Based on interviews with clinicians, CMS created the Explores Measures tool, which enables clinicians and practice managers to select measures that likely fit their practice, assemble them into a group, and print or save them for reference. Already, tens of thousands of people are using this tool.

NRHI and several other groups applaud the release of this tool, including: the American Academy of Ophthalmology, American College of Radiology (ACR), American College of Physicians (ACP), National Rural Accountable Care Consortium, Great Lakes PTN, Pacific Business Group on Health, Compass PTN, TMF QIN-QIO, and the Mountain Pacific Quality Health Foundation.

The MACRA Playbook: National MACRA MIPS/APM Summit

November 30 – December 2, 2016
Washington, D.C.
Macra_Playbook

NRHI is co-sponsoring this dynamic hybrid conference and internet event that offers content and tips for every stakeholder in healthcare.

Choices must be made about how to implement the provisions of MACRA, and these choices will have profound impacts on the future of healthcare. Although the provisions of MACRA are directed specifically at physicians, the incentives and accountability required under MACRA will affect every healthcare provider— hospitals, nursing homes, home health agencies, etc.—and it will affect health plans and employers that contract with physicians.

The MACRA Summit seeks to provide deep insights into the choices under MACRA and their implications, and it will feature many examples of innovative approaches to healthcare payment and delivery that can help achieve the goals of MACRA.

Join us at the Hyatt Regency on Capitol Hill, Washington, D.C. For more information visit and to register click http://www.macrasummit.com. As an NRHI Member, enter the discount code “NRHI” and participate at the reduced rate of $995 to attend onsite and $595 to attend online (via live and archived for 6 month video Internet Broadcast).

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MACRA 201 Webinar: Technical Assistance
View the video here.

On Monday October 31, HealthDoers Network hosted an interactive conversation with Lisa Letourneau of Maine Quality Counts, with additional contributing speakers who represent multiple stakeholder perspectives. This conversation will serve as a deeper dive (“201-level”) into how Technical Assistance is critical to MACRA implementation. Other speakers featured:

  • Sharon Donnelly, Senior Vice President, HealthInsight Utah
  • Sara Medley, CEO, Mountain-Pacific Quality Health
  • Elizabeth Mitchell, NRHI President and CEO
  • Stacy Donohue, Senior Program Manager, NRHI High-Value Care Support and Alignment Network

Talking MACRA 101
View the video here.

3 Top Questions with Elizabeth Mitchell, President and CEO, NRHI

A brief video Q&A about why MACRA matters, who will feel its effects (hint: everyone), and how it will affect the marketplace.

MACRA Checklist: Steps You Can Take Now to Prepare
Read the list here

From the American Medical Association

A brief, informative list of housekeeping steps providers can take to get ready for MACRA implementation – even before the final rules are published.

HealthDoers Monthly Engagement Call
Watch the panel presentation

Spotlight Topic: MACRA 101

With insights on MACRA from both regional and national perspectives, this panel presentation includes a “MACRA 101” segment by NRHI CEO Elizabeth Mitchell, and Tim Gronniger from HHS/CMS, beginning with an introduction at 13:39. Their presentations are followed by a lively, informative Q&A session.

Administration takes first step to implement legislation modernizing how Medicare pays physicians for quality
Read the original post

from HHS.gov | April 27, 2016

CMS Finalizes its Quality Measure Development Plan

Read the full post
The CMS Blog | MAY 2, 2016

Post by Kate Goodrich, M.D., M.H.S., Director, Center for Clinical Standards & Quality, CMS

What Does A New Era Of Physician Accountability Mean For Patients?
Read the full post

Health Affairs Blog | April 26, 2016

Post by Steven Findlay from Health Affairs Blog.

What are the MACRA, SGR, MIPS, and APM?

Watch the interactive video
National Quality Forum | Interactive Video Series

The sixth video in NQF’s Policy Playlist series.

Medicare Physician Fee Schedule Merit-Based Incentive Payment System
and Alternative Payment Model Incentives Proposed Rule

Read the full document
Prepared for NRHI by Akin Gump

A complete, technical and accurate MACRA summary from Akin Gump Strauss Hauer & Feld LLP.


Alternate Payment Models

HealthDoers Monthly Engagement Call

Watch the panel presentation
Spotlight Topic: MACRA 101

With insights on MACRA from both regional and national perspectives, this panel presentation includes a “MACRA 101” segment by NRHI CEO Elizabeth Mitchell, and Tim Gronniger from HHS/CMS, beginning with an introduction at 13:39. Their presentations are followed by a lively, informative Q&A session.

Administration takes first step to implement legislation modernizing how Medicare pays physicians for quality
Read the original post here

from HHS.gov | April 27, 2016

What Does A New Era Of Physician Accountability Mean For Patients?

Read the full post here 
Health Affairs Blog | April 26, 2016

Read the full post by Steven Findlay from Health Affairs Blog.

What are the MACRA, SGR, MIPS, and APM?

Watch the interactive video
National Quality Forum | Interactive Video Series

The sixth video in NQF’s Policy Playlist series.

Medicare Physician Fee Schedule Merit-Based Incentive Payment System
and Alternative Payment Model Incentives Proposed Rule

Read the full document here
Prepared for NRHI by Akin Gump

A complete, technical and accurate MACRA summary from Akin Gump Strauss Hauer & Feld LLP.


Data Sharing

HealthDoers Monthly Engagement Call

Watch the panel presentation
Spotlight Topic: MACRA 101

With insights on MACRA from both regional and national perspectives, this panel presentation includes a “MACRA 101” segment by NRHI CEO Elizabeth Mitchell, and Tim Gronniger from HHS/CMS, beginning with an introduction at 13:39. Their presentations are followed by a lively, informative Q&A session.

NRHI RFI Comments

Read the document
A new vision for new payment models.

Drafted in response to the Centers for Medicare & Medicaid Services’ Request for Information, this document provides our perspective on how payments might be evaluated under MACRA.


Measurement

HealthDoers Monthly Engagement Call

Watch the panel presentation
Spotlight Topic: MACRA 101

With insights on MACRA from both regional and national perspectives, this panel presentation includes a “MACRA 101” segment by NRHI CEO Elizabeth Mitchell, and Tim Gronniger from HHS/CMS, beginning with an introduction at 13:39. Their presentations are followed by a lively, informative Q&A session.

CMS Finalizes its Quality Measure Development Plan

Read the full post
The CMS Blog | MAY 2, 2016

Read the full post by Kate Goodrich, M.D., M.H.S., Director, Center for Clinical Standards & Quality, CMS

What are the MACRA, SGR, MIPS, and APM?
Watch the interactive video

National Quality Forum | Interactive Video Series

The sixth video in NQF’s Policy Playlist series.


Technical Assistance

HealthDoers Monthly Engagement Call

Watch the panel presentation
Spotlight Topic: MACRA 101

With insights on MACRA from both regional and national perspectives, this panel presentation includes a “MACRA 101” segment by NRHI CEO Elizabeth Mitchell, and Tim Gronniger from HHS/CMS, beginning with an introduction at 13:39. Their presentations are followed by a lively, informative Q&A session.


Voices from the Field

During the July 2016 MACRA Peer to Peer Seminar, NRHI talked with different stakeholders about where they and their organizations are in terms of understanding and implementing MACRA, and what they would find most helpful if they could ask anything of the Center for Medicare and Medicaid Services (CMS). “Voices From the Field” offers, in their own words, valuable insights and a snapshot of where different regions stand with the new rules.


“We Need to Have the Patient’s Voice at the MACRA Table”
Bill Adams, Consumer/Consultant, Winding Road Communications, Minnesota

As an active member of the patient advocacy group, Baby Boomers for Balanced Health Care, Bill Adams is dedicated to establishing balanced care, or, as the group’s motto describes it, “Goldilocks health care: not too much, not too little – but just right!” By bringing the patient’s voice to local, regional and national conversations, the group works to ensure better access, affordability, understanding of one’s own health and care options and seeks to prevent overuse.

Bill raised eyebrows at the MACRA event as well as many stakeholders awareness levels when he quietly stated, “I hear you want all the players at the table and I’m not sure the patients are at the table … I don’t think patients know anything about this. The number one thing should be how is this going to improve patient care.”

Bill contributed significantly to the group’s list of Emerging Practices for Patients, which includes understanding MACRA’s potential to improve care quality and reduce costs, and read, learn and engage with providers and other community healthdoers.

To hear more of Bill’s thoughts around how CMS and other stakeholders can engage patients in MACRA click on the video link.

NRHI_MACRA_Bill Adams from NRHI on Vimeo.


“The federal government has to create an understandable, workable system in order for small practices to be successful under MACRA”
Mike Sayama, Executive Director, Community First, Hawaii

As Executive Director of Community First, one of NRHI’s two member Regional Health Improvement Collaboratives (RHICs) in Hawaii, and Vice President and Executive Director of Learning Health Homes at Pono Corporation, Mike Sayama works to create a sustainable health care system through payment reform, information integration, care coordination, and community engagement.

During the July MACRA Peer to Peer event, he calmly, yet passionately, called for an understandable, sustainable business model to allow providers to be successful under MACRA.

“When you think about it, our doctors are islands operating on islands,” is how he described the small, rural practices that are members of his RHIC. By necessity, they are innovative and flexible in terms of the care they give, interconnected with social service agencies, and closely involved in helping patients to figure out insurance coverage and affordability.

“I believe that the direction that MACRA is going is correct – value over volume,” says Mike. “But what makes it impossible is that if they have to deal with MACRA plus other commercial plans which have different payment structures. That just creates an impossible situation for them to manage all that.”

Click the video link below to hear Mike’s suggestions for how CMS can build a coherent business model under MACRA that is workable for providers and communities.

NRHI_MACRA_Mike Sayama_r2 from NRHI on Vimeo.


“CMS has a responsibility to require interoperability under MACRA.”
Jerry Reeves, MD, Senior Vice President, HealthInsight Nevada, New Mexico and Utah

As the Senior Vice President for HealthInsight of Nevada, New Mexico and Utah – one of four NRHI Qualified Improvement Organization (QIO) members – and a pediatric oncologist, Jerry Reeves brings a unique perspective from the intersection of provider experience and the necessity for accurate cost/quality measurement.

He strongly advocates for what he terms “interoperability” under MACRA. “What we find is that the electronic health record manufacturers don’t connect to the other electronic health records. Our purpose is to build an interface or to match the interface of all these electronic health records so the common fields like waist size or blood pressure or body mass index or various clinical measures, besides the claims data, all connect.”

As this would dramatically reduce duplicative reporting and documenting for providers while significantly improving patient experience and possibly health outcomes, Jerry sees it as a basic responsibility of CMS to require and enforce interoperability under MACRA.

To hear more of his thoughts on how to build interoperability into the system, click the video link below.

NRHI_MACRA_Jerry reeves_r1 from NRHI on Vimeo.


MACRA will force more provider group consolidation and drive up the cost of healthcare.”
Cara Brioch, Director, Quality Improvement, Medica, Minnesota

Cara Brioch has witnessed constant and widespread consolidation of small practices in Minnesota during her years with Medica, a health insurance organization in Minnesota. She is calling on CMS to consider consolidation, the impact it will have on small practices in combination with MACRA, and to build in appropriate supports to enable independent providers to succeed under the new rules.

“When you are comparing a group of one thousand physicians, and the data analytic skills that they are going to have as well as the quality improvement opportunities that they have, versus a five doctor practice, you are not comparing apples to apples,” says Cara.

Cara makes the case that providing data and reporting support for small practices will prevent widespread monopolies from forming while simultaneously keeping health care costs from rising.

Hear Cara in her own words by clicking on the video link below.

NRHI_MACRA_Cara Brioch_r1 from NRHI on Vimeo.