How physicians will steer implementation of the SGR repeal law

The Medicare Access and CHIP Reauthorization Act (MACRA), the law that eliminated the sustainable growth rate (SGR) formula, has a variety of provisions physicians need to know—and many implications for the future of Medicare. Learn how physicians will work to influence how the law is put into practice.

MACRA will do a lot of things, including:

• Change payments and penalties for physicians in fee-for-service practice by aligning quality reporting programs into one merit-based incentive payment system (MIPS)
• Provide important medical liability protections by incorporating the Standard of Care Protection Act
• Ensure access to care for kids by extending funding for the Children’s Health Insurance Program, which provides low-cost health care coverage to kids in low-income families who don’t qualify for Medicaid
• Support physician transitions to new payment models by providing 5 percent bonus payments, technical assistance grants and establishing a payment models advisory committee

Last month, the AMA convened a meeting with leaders from 19 specialty and state medical societies to discuss key elements of MACRA and how physicians can successfully navigate the new law.

To start, the AMA will educate physicians about the coming changes and develop resources to help them understand their options and choices under MACRA, particularly those in small and independent practices. The AMA also will develop mechanisms to ensure frequent communication and good cooperation with all the state societies and national specialty societies as the regulatory and implementation process gets underway.

Here are more ways the AMA is working to make MACRA implementation beneficial for patients and their physicians:

• Although maximum penalties under the MIPS will be lower than potential penalties under previous law, the MIPS program will only be as good as the programs rolled into it. To make the MIPS useful, improvements must be made to the electronic health record meaningful use program, Physician Quality Reporting System and value-based modifier.
• The support for alternative payment models is encouraging, but the medical community needs to be engaged in designing the new models to make sure they break down the barriers and allow needed flexibility to improve patient care.
• The AMA will develop two workgroups—one to focus on the MIPS, one to focus on the alternative payment models pathway—to build on physician experiences and best practices as implementation proceeds.

MACRA also authorizes a Physician-Focused Payment Model Technical Advisory Committee, which will review proposed models and provide recommendations to the U.S. Department of Health and Human Services. The Comptroller General of the United States will appoint the 11 committee members this October.

Participants at the AMA-convened meeting stressed the need to develop consensus on a set of principles, such as fairness and transparency, to guide future steps on MACRA implementation.

Learn more about the MACRA and access FAQs about the new legislation.