Dr Mark McClellan on Reducing Administrative Burdens in Move to Value-Based Care

CMS has been making efforts to reduce administrative burdens for physicians as the healthcare industry moves to value-based care through the implementation of the Medicare Access and CHIP Reauthorization Act (MACRA), said Mark McClellan, MD, PhD, director of the Duke-Margolis Center for Healthy Policy.

Transcript

What changes in the MACRA final rule were you pleased to see?

Several important changes in the rule. One is a lot of steps to try to make it easier for small healthcare organizations, small physician practices, and smaller ACOs [accountable care organizations] and the like, to do well under the new payment models. For example, a lot of efforts to relax the MIPS reporting requirements for small physician practices that are reporting that way. Also it hints at a new pathway for ACO participation as an advanced payment model for smaller, physician-led ACOs.

How will physicians handle the new alphabet soup of MACRA, MIPS [Merit-based Incentive Payment System], and APMs [Alternative Payment Models]?

Physicians are handling a lot now in terms of administrative burdens and alphabet soups and lots of reporting and other requirements to participate in programs like Medicare. One of the things that Andy Slavitt, the [former] CMS administrator, emphasized when releasing the rule is that he felt like they had lost the hearts and minds of physicians. That the programs intended to improve quality of care and reduce costs had maybe noble aims, but had become disconnected in terms of their application in practice, turning instead into the check-the-box reporting, requirements, and lots of administrative burden.

So CMS has announced a major new initiative to try to address that, to try to bring down the administrative burdens, and simplify reporting requirements. It's not clear yet that will work, but one of the things we are emphasizing in our work at Duke University is finding successful models of practices both small and large that are moving into alternative payment models, succeeding financially, and getting the administrative burdens down. It can be done; unfortunately, it's not very common today.