Statement from HCI3 Regarding Proposed MACRA Regulations

Statement from HCI3 Regarding Proposed MACRA Regulations

More APM Options Needed

Media Contact: Cary Conway

WASHINGTON — June 28, 2016 — The Health Care Incentives Improvement Institute (HCI3) applauded when the Sustainable Growth Rate was replaced with a framework for rewarding clinicians for value instead of volume under the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA). In response to the Centers for Medicare and Medicaid Services’ (CMS) recent request for comments, HCI3 cautions that changes to the proposed regulations for implementing the Merit-Based Incentive Payment System (MIPS) and Alternative Payment Model (APM) incentives are necessary to achieve the law’s full potential and intent.

“We are concerned that without important revisions the rule may slow progress in the current movement to broadly adopt alternative payment models,” said François de Brantes, HCI3 executive director. “CMS’s proposal to ignore bundled payment models as advanced APMs, despite their broad appeal and substantial evidence of effectiveness, will cause significant harm to widespread adoption of APMs if it stands as written.”

Global payments for episodes of care—which are now commonly referred to as bundled payments—are being widely implemented by private sector payers; employers; several state Medicaid programs, including New York’s; and CMS. If these programs are not designated as an Advanced Alternative Payment Model, there is a real risk that the national movement toward value-based payment will be set back.

HCI3 submitted a letter to CMS Acting Administrator Andy Slavitt with recommendations on how slight modifications to the current rule could enable bundled payments to be accepted as advanced APMs. The full letter with recommendations can be found here.

About HCI3
Health Care Incentives Improvement Institute, Inc. (HCI3®) is a not-for-profit organization that aims to create significant improvements in the quality and affordability of health care through evidence-based incentive programs and support of payment reform models. Its nationally recognized programs, Bridges to Excellence® and PROMETHEUS Payment® have been at the forefront of payment reform, and the new PROMETHEUS Analytics® offers transformational insights for payers and providers.

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