Hard to Assess Year One of MACRA, Says Expert

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Pam Minichiello, principal consultant at the Massachusetts eHealth Collaborative (MAeHC), returns to the Physicians Practice Pearls podcast to discuss how practices have done in year one of the Medicare Quality Payment Program (QPP) and look ahead to year two.

Last year when she spoke to us, Minichiello had an optimistic outlook on how small practices would do in the QPP, more commonly known referred to by the acronym of the law which passed it into existence - the Medicare and CHIP Reauthorization Act (MACRA). One year later, she says the "pick your pace" flexibilities offered in MACRA's Merit-based Incentive Payment System (MIPS) pathway make it hard to thoroughly assess whether or not she still believes this. "It's really just [been] a test year," she noted on the podcast.

In working with small and medium-sized practices through her work at MAeHC, Minichiello did see some difficulties in year one and some encouraging signs. "The overall [advancing care information] portion of MIPS and MACRA align with the Meaningful Use objectives they're used to…That hasn't posed a lot of challenges. Where we are seeing the challenges is with quality data," she said. Quality, as she notes, is 60 percent of a physician's MIPS score in year one and similarly high in year two.

For year two (2018), Minichiello said the recently published final rule should remove any doubts over whether or not CMS is committed to this program. "That final rule proves this is real, you have to consistently work towards this and work pretty aggressively," she said.

Later in the podcast, Minichiello talked about her experience in the field, helping small and medium-sized practices implement the Comprehensive Primary Care Plus (CPC+) initiative. She explained how CPC+ can help practices succeed in MACRA and provided insight on the difficulties of providing care management for patients of a certain age.