Practice Rounds: CMS Announces Flexibility for MACRA

Welcome to Practice Rounds, our weekly column exploring what's being covered in the larger world of healthcare.

CMS Allows Providers to "Pick Your Pace" On MACRA

This week, CMS Acting Administrator Andy Slavitt wrote a blog announcing flexibility for physicians in complying with Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) regulations next year. Under the original guidance, complying with MACRA's Merit-Based Incentive Payment System (MIPS) or Alternative Payment Models (APM) paths would have a positive or negative effect on physicians' Medicare reimbursement revenue in 2019. While this will still be the case, the announcement from CMS ensures compliance rules next year will not be as rigid. Slavitt announced four potential options for physicians to ensure they do not receive a negative payment adjustment:

-First option: Test the program. For this one, physicians can submit some data to the quality payment program next year and will avoid a negative payment adjustment. It's simply designed to ensure that a physician's system is working for extensive compliance in 2018 and 2019.

-Second option: Participate for part of the calendar year. If you submit data for MACRA compliance for part of the year, starting with a performance period after Jan. 1, 2017, you may receive a slight positive payment adjustment.

-Third option: Participate the full year. If you submit data for MACRA compliance for the whole year, starting on Jan. 1, 2017, you may receive a more modest positive payment adjustment

-Fourth option: Participate in an APM. Rather than comply with MIPS regulations, providers can participate in an APM, such as the Medicare Shared Savings Model. If they receive enough of their payments through an APM in 2017, they would receive a 5 percent positive incentive payment.

Physicians Practice will have more on this developing story, soon.

Closing Loophole in NPDB

Public Citizen, a nonprofit advocacy group, is working to change a loophole that allows providers to not have to report to the National Practitioner Data Base (NPDB). The NPDB opened in 1990 to give healthcare entities records of malpractice payouts and adverse actions, Medical Economics reports. The loophole specifically allows providers to skip the NPDB if a "malpractice plaintiff agrees to dismiss the practitioner from a lawsuit or claim, leaving a hospital or other corporate entity as the sole defendant." Public Citizen told Medical Economics this loophole makes the NPDB less complete and less reliable.

EHRs a Major Pain for Docs

A widely-circulated study from the Annals of Internal Medicine revealed that physicians are spending a lot more time documenting on EHRs compared to the amount of time they spend face-to-face with patients. Specifically, the researchers say that physicians spent 27 percent of their time face-to-face with patients and nearly 50 percent of their time using the EHR and completing desk work. Even in the examination room with the patients with them, doctors were still spending 37 percent of the time working on the EHR, compared to interacting with the patient face-to-face. The researchers observed 57 physicians in four states for the study.

Quote of the Week:

Docs, Admin Don't Trust Each Other, Says Leadership Expert

"Doctors distrust the administrators and the administrators distrust the doctors. Both think the other side is only after money and there is that disconnect."

Mark Hertling, Ret. Lt. General, Physician Leader Expert