WASHINGTON – Don’t rush implementation of the Medicare Access and CHIP Reauthorization Act (MACRA).
This was the message Dr. Jeffrey Bailet, co-president of Aurora Health Care Medical Group, Milwaukee, gave to the House Energy & Commerce Health Subcommittee during an April 19 hearing to review the reform law 1 year after its passage.
“My caution is that we cannot move too quickly,” Dr. Bailet said. “I know there is a pressing urgency to move forward and I respect that, but I also think if we go too fast and we strip out the physicians who are already struggling with burnout ... this could tip things out of balance and that could take something as wonderful as MACRA and essentially harm its ability and its effectiveness.”
Dr. Bailet identified data infrastructure as the biggest need to help ensure the success of MACRA. And while full-fledged use of electronic health records is essential, the more important piece is what can be done with the data that is collected.
“Until you develop infrastructure that can analyze [the data], compartmentalize it, and stratify your patients [as to] where you are going to deploy your resources in the most critical areas, you are not going to be able to provide the kind of care at the cost that is going to make this successful,” Dr. Bailet testified.
His perspective was buttressed by Dr. Robert Wergin, board chair for the American Academy of Family Physicians, who stressed the “critical importance of electronic health records” to the implementation of MACRA. “AAFP has also shared recommendations regarding the importance of issuing regulations that are less cumbersome and more user friendly for physicians,” he said.
Dr. Barbara McAneny, immediate past chair of the American Medical Association, outlined three distinct features that would support successful MACRA implementation: consolidated reporting measures to make them as less burdensome; a clear pathway for approval of alternative payment models so that a broader part of the physician community can participate; and improved, meaningful quality measures.
Dr. Robert McLean, chair of the American College of Physicians’ medical practice and quality committee, echoed the need for improved quality measures and streamlined reporting as well as multiple, realistic ways for patient-centered medical homes to obtain certification and promote innovation.
“I truly believe that MACRA can be a shot in the arm to combat burnout if it is rolled out as intended,” Dr. McLean said.