CAPG Chimes In On MACRA

The California Association of Physician Groups (CAPG) has mostly praised the Medicare Access and CHIP Reauthorization Act (MACRA).

            MACRA, which was signed into law last year, is meant as the replacement for the Sustainable Growth Rate (SGR) formula, the much-maligned and rarely employed formula to determine how physician payments from the Medicare program are adjusted on an annual basis.

            MACRA includes a variety of incentive programs for solo and group medical practices to improve quality and bear some financial risk for outcomes. The Centers for Medicare & Medicaid Services is expected to issue a final rule later this year or in early 2017.

            “MACRA sets the country on the right path forward, toward the risk-based coordinated care

models that our members have proven can be successful,” said the CAPG comment letter, authored by CAPG Chief Executive Officer Don Crane. “By putting an end to the relentless cycle caused by the sustainable growth rate formula, consolidating fragmented reporting programs and creating an incentive for risk-based coordinated care, MACRA puts traditional Medicare on a firmer foundation to meet the needs of the aging population in the future.”

            However, Crane and CAPG did find some flaws in the proposed MACRA rules. They included a lack of certainty for physician practices and organizations that pursue an alternative payment model to meet quality and outcome demands. The alternative performance program, the Merit-Based Incentive Payment System, or MIPS, has a greater chance for incentive payments but relies on the overall performance of all participants in order to achieve it.

            The CAPG also asked that Medicare Advantage data be added to the Physician Compare rating service and develop new physician group-focused payment models.

            The response from CAPG is more upbeat than the comment submitted by other physician organizations. The American Medical Association not only asked for more streamlining of the MIPS program but that the U.S. Department of Health and Human Services issue only an interim final rule in order to implement further changes to MACRA in the future.