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MACRA an “Encouraging First Step” for Patient-Centered Care

MACRA shifts how the nation pays for healthcare, rewarding value-based and patient-centered care over fee-for-service models, says the National Partnership for Women & Families.

By Sara Heath

MACRA will bring the healthcare system one step closer to patient-centered, value-based healthcare, says the National Partnership for Women & Families, according to a recent press release.

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In a comments letter sent to the Centers for Medicare & Medicaid Services (CMS) with regard to the Medicare Access and CHIP Reauthorization Act (MARCA), National Partnership representatives stated that the law shows promise, but needs fine tuning to deliver fully person-first healthcare.

“MACRA’s Quality Payment Program has the potential to be a catalyst for changing how our nation pays for health care and moving us away from fee-for-service and toward value-based payment,” said National Partnership president Debra L. Ness. “But to be successful, CMS and participating providers must give as much attention to improving the delivery of care as they do to reducing spending.”

“As it finalizes the MACRA rule, CMS can consistently support this balance by prioritizing high-quality measures, robust use of health information technology, continuous practice improvement and meaningful patient and family engagement,” Ness continued.

Specifically, the National Partnership said CMS should add more provisions to the Advanced Alternative Payment Models (Advanced APMs) that are a part of the law’s Quality Payment Program. By adding a provision requiring APMs to demonstrate how it will help deliver patient-centered, value-based care, MACRA can better ensure health system improvement.

“Ultimately, APMs should enable us to achieve all three tenets of the Triple Aim – better health outcomes, better experience of care, and lower costs – but they can do so only if they engage and meet the needs of the patients they serve and improve how care is delivered,” the National Partnership said in its comments.

The National Partnership also stated that MACRA’s Quality Payment Program should include quality measures for patient-centered care under the Merit-Based Incentive Payment System, and should adjust the role of clinical practice improvement activities (CPIAs) under MIPS to create data-driven and evidence-based results.

With regard to the advancing care information performance category under MIPS, the National Partnership said CMS should boost the “one patient” threshold, which requires providers to secure message, provide and e-prescription, or share health data with only one patient.

Similar sentiments were mirrored by the Consumer Partnership for eHealth, an organization led by the National Partnership.

In a comments letter also released this week, CPeH stated that CMS should increase the “one patient” threshold to five percent of a provider’s patient, stating that such actions would better support CMS’s stated goal of creating a culture of patient-centered healthcare.

“Keeping the ‘one patient’ threshold – and broadening its application to all measures (not just View/Download/Transmit and Secure Messaging) – undermine CMS’s commitment to make patients and family caregivers true and equal partners in improving health through shared information and shared decision-making,” the CPeH said in it is comments letter.

Ultimately, however, both CPeH and the National Partnership said they support and approve of CMS’s measures to improve person-first healthcare under its proposed MACRA rule.

“The MACRA rule CMS has proposed is a catalytic and encouraging first step in driving the health care system transformation our country urgently needs,” Ness said on behalf of the National Partnership.

“It moves the country away from payment models that reward volume rather than quality or value,” she continued. “We urge agency leaders to adopt these recommendations, which will advance high-quality, patient- and family-centered care for millions of people.”

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