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    Physicians ready practices for 2018 MACRA rule


    “I think they should ditch the whole thing until they can prove they are actually improving anyone’s care, and they have made it as simple and less-burdensome as possible,” says Vikki Stefans, MD, of Arkansas Children’s Hospital. She suggests a pilot project should be done to prove the concept before its required of all physicians. “I thought there was some interest in combating physician burnout—if so, why are we all facing even more detailed and extensive paperwork and calculations that only detract from what our patients need and want?”

    Melissa Lucarelli, MD, a solo practitioner in rural Randolph, Wisconsin, likes the additional flexibility for smaller practices, but wonders if further changes are coming.

    “I am most apprehensive about the fact that the final rule doesn’t seem to be finalized yet,” says Lucarelli, a member of the Medical Economics Editorial Advisory Board. “Although groups will be expected to attest to 12 months of quality data beginning in January 2018, CMS admits that it is still ‘soliciting feedback on some of these measures,’ possibly through fall of 2018.”


    RELATED READING: Best ways to boost practice performance


    Panjamapirom says the 2018 rule is final, but that CMS still wants feedback from providers to gauge satisfaction with the most recent changes and to gather suggestions for future modifications.

    He says that CMS is doing what it can to reduce the regulatory burden within the framework of the law, but changes that some are unhappy with this year—such as the inclusion of cost in the MIPS formula—are to lessen the transition in 2019.

    “CMS thought it would be too dramatic of a change from 2018 to 2019 if they didn’t include cost now,” says Panjamapirom. “It’s a statutory requirement that cost be 30% in 2019. If you go from zero to 30% in one year, they were afraid that would be too big of a jump, so they moved cost to 10% in 2018.”


    Todd Shryock
    Todd Shryock, contributing author


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