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Expert argues for improving MACRA, not scrapping it

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Dr. Michael E. Nelson argues for improving MACRA, not scrapping it

Michael E. Nelson, MD, FCCP, comments: Dr. Wilensky made some cogent arguments as to why scrapping MIPS may not be such a good idea. In my mind, however, the final paragraph of the editorial was the most important. “Practicing physicians need make their views about the MIPS and its alternatives known to their representative medical groups and, if necessary, to their representatives in Congress as well. In the past, practicing clinicians have been woefully bad at making their voices heard. Now is a good time for that to change.” Your future is being decided without you. The squeaky wheel gets the grease.

Dr. Michael E. Nelson


 

FROM NEW ENGLAND JOURNAL OF MEDICINE

Even given the notable problems and challenges associated with Medicare’s Merit-based Incentive Payment System (MIPS), the program should be improved via pilot programs and demonstration projects, according to Gail R. Wilensky, PhD, economist and senior fellow at Project Hope and a former top health aide to President George H.W. Bush.

Dr. Gail Wilensky, economist and senior fellow at Project Hope and a former top health aide to President George H.W. Bush

Dr. Gail Wilensky

The Medicare Payment Advisory Committee (MedPAC) is set to recommend to Congress that the MIPS portion of the value-based reforms enacted under the Medicare Access and CHIP Reauthorization Act (MACRA) be eliminated and replaced with a Voluntary Value Program. MedPAC’s report is due to Congress in March.

“Although I agree with MedPAC about the problems it has identified, I am also concerned about the commission’s proposal,” Dr. Wilensky wrote in an editorial published in the New England Journal of Medicine (doi: 10.1056/NEJMp1801673). She noted that a lack of support from major medical associations, combined with the impending midterm elections, means that it would be challenging to get a legislative fix through Congress.

Read her suggestions on how to improve MIPS in the New England Journal of Medicine.

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