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    Is MACRA legal?

    Editor’s Note: Welcome to Medical Economics' blog section 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 Medical Economics or UBM Medica.

     

    Dr. KartsonisOn 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.

     

    Related: 6 things doctors need to know about MACRA final rule

     

    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.

    Next: MACRA is a "flagrant violation of the Medicare law"

    Louis P. Kartsonis, MD
    Lou Kartsonis is an ophthalmologist in San Diego. He can be reached at [email protected]

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    • john.street@------.com
      The burden of MACRA, as it is with all these quality programs, is solely on the provider community. Patient compliance is a non-factor who will end up utilizing more resources (not to mention waste provider time) and drive up costs. And for all their time and energy, providers will be held accountable. Sounds about right for government work.
    • lawrence.young@------.com
      Our Medical Societies are too busy enriching themselves to stand up to the forces that permit them to act in this matter. We, as the physicians in the trenches who will be impacted by this bureaucratic burden would be better off filing a class action suit.
    • rngaster@------.edu
      ...and the sooner the better.

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