CMS’s Slavitt says MACRA could be delayed

Testifying before the Senate Finance Committee, CMS Acting Administrator said it’s possible the agency will push back the Jan. 1, 2017 date for physicians to begin reporting under new standards set up by the Medicare Access and CHIP Reauthorization Act (MACRA).

Sen. Orrin Hatch, R-Utah, chairman of the committee, asked Slavitt whether the agency would delay or modify the reporting period, given that the MACRA law leaves the start date up to CMS to decide.

Slavitt responded by saying a delay, and many other ideas, are still being discussed.

“We need to launch this program so that it begins on the right foot, and that means that every physician in the country needs to feel like they’re set up for success,” Slavitt said. “This has been a significant source of feedback we’ve received…and we remain open to multiple approaches.”

Among the options Slavitt said CMS is considering were a later start date, shorter reporting periods, and letting physicians “get experience with the program before the impact really hits them.”

Hatch then borrowed a suggestion made by the American Medical Association and other groups, asking Slavitt whether CMS would implement an “interim final rule” to allow for another comment period. That too appears to be on the table.  

“We know that this is a long-term process,” Slavitt said. “We know that we are only taking the first step in the first years of implementation, so we know we have to have processes that allow physicians to continue to provide feedback to us.”

The American Medical Informatics Association had made the same suggestion on an interim rule.  

Members of the committee from both parties complimented CMS on how it has reached out to healthcare professionals regarding the proposed MACRA rule, along with some comments celebrating the end of the “hopelessly broken” sustainable growth rate formula.

“What our committee has learned is this is not our grandfather’s Medicare program,” said Sen. Ron Wyden, D-Ore., the ranking Democrat on the committee.

Along those lines, he asked Slavitt how MACRA could benefit the changing Medicare population, such as beneficiaries who may have multiple chronic illnesses. Slavitt said his hope is implementing MACRA allow physicians to spend more of their day seeing patients, and less time on paperwork.

“New approaches to payment must emphasize the ability to coordinate care for people who have multiple chronic conditions and to give physicians time to do that,” Slavitt said.

Slavitt said the agency is considering expanding higher reimbursements for those chronic patients, along with encouraging greater use of alternative models like bundling and medical homes.