Early on the morning of February 10th, the Senate approved
the nomination of now-former Rep. Tom Price to be the Secretary of Health and Human Services. While some say his chief priority is “dismantling of the Affordable Care Act” (Sen. Maria Cantwell of Washington), the tasks that will be put in front of him also include five major health IT initiatives: appointments to ONC and other agencies, the future of MACRA and Meaningful Use, the enforcement of interoperability, telemedicine, and cybersecurity.
Specifically, looking at how Price will potentially impact MACRA and MIPS program policy, we can look to his confirmation hearings. The ‘Questions for the Record’ document provides insight into Price’s positions regarding MACRA.
On MACRA
"If confirmed, I commit to work closely with the CMS Administrator to make sure we implement MACRA in a way that is easy to understand, minimizes burden, and is fair to all affected providers."[1]
On MACRA and Value Based Payment
“The Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) is built on the principle of encouraging providers to develop Alternative Payment Models (APMs) that can ultimately be adopted by CMS and commercial payers.” [1]
On Value Based Payment
“We share the goal of improving Medicare by empowering providers to be creative and develop payment models that best suit the unique needs of their patients to ultimately improve patient care.”[1]
On the Merit-based Incentive Payment System (MIPS)
“The recent CMS MACRA final rule approached the first year of the Quality Payment Program as a transition year, and took steps to address physician concerns regarding the burdens associated with program participation. I think significant challenges remain with respect to provider burden, and, if confirmed, I plan to direct the CMS Administrator to ensure that the program is structured to achieve its quality and budgetary goals, while ensuring that patients and the providers who care for them are at the center of our reform efforts.”[1]
What This Means for the Future of MACRA
Most agree that the reformation of MACRA and MIPS is not high on the list of priorities for HHS this year, it appears as if the current program for 2017 will be left in-tact. We do know that when CMS published the MACRA final rule on October, Price issued the following statement: "We are deeply concerned about how this rule could affect the patient-doctor relationship, and I look forward to carefully reviewing it in the coming days to determine whether the Administration has addressed those concerns and put the interests of patients first.” We have not seen a follow-up from him since this statement.
The Affordable Care Act is separate from both Meaningful Use and MACRA. The repeal of the ACA does not reverse requirements for MU and MACRA. On top of that, most payment reform is not within the ACA and therefore is not subject to the debate on what happens with repeal/replace. In addition, the Price-led HHS has a short runway to determine the 2018 version of MACRA. Healthmonix will continue to seek out statements and news about the current administration’s views and actions specifically regarding MACRA and MIPS.
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Sources:
[1] http://static.politico.com/b8/dd/542cf7084be185c759497c910b93/rep-tom-prices-questions-for-the-record-to-senate-finance-committee.pdf
