Is MACRA legal?
Editor’s Note: which features contributions from members of the medical community. These blogs are an opportunity for bloggers to engage with readers about a topic that is top of mind, whether it is practice management, experiences with patients, the industry, medicine in general, or healthcare reform. The series continues with this blog by Louis P. Kartsonis, MD, an ophthalmologist in San Diego, California. The views expressed in these blogs are those of their respective contributors and do not represent the views of or UBM Medica.
On Oct. 14, 2016, the Department of Health & Human Services published its final rule on the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA). MACRA, passed each chamber of Congress with over 90% of the vote and became law on April 16, 2015.
The rule, a 2,398-page leviathan, glutted with bureaucratic blather, empowers the federal government to regulate payments under Medicare and change the way physicians care for patients. Those who don’t participate will be punished with cuts to their Medicare reimbursements beginning in 2019.
Despite MACRA’S transformative impact on medical practice, only 50% of non-pediatric physicians have heard of it, according to a July 2016 survey by Deloitte1.
Compliance with MACRA will require that physicians spend a good part of their working day mired in administrative inertia. The big loser in this scenario will, of course, be the doctor-patient relationship.
Further reading: Small practices get relief in final MACRA rule
Instead of answering patients’ questions and explaining the nuances of their ailments, physicians will be staring at their computer screens trying to keep up with onerous new reporting requirements. In a report by the Ethics & Public Policy Center published in the Wall Street Journal, only one-quarter of the 333 accountable care organizations (a subset MACRA’s Alternative Payment Model) received bonus payments in 2014 for meeting performance targets2.