Will MACRA Survive? Should I Wait to See What Happens?

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December 15, 2016

In This Article

Rescinded, Repealed, or Revised?

Now that a new administration will be taking office—one that has vowed to make huge changes in healthcare—many doctors are wondering whether the Medicare Access and CHIP Reauthorization Act (MACRA) is going to change substantially, or even go away. That raises the question: If that chance exists, why bother to start quality reporting and making changes to one's practice and workflow?

Healthcare policy experts noted that Dr Tom Price, the nominee for Secretary of Health and Human Services (HHS), voted for MACRA, which has bipartisan support. On the flip side, many Republican politicians have vowed to "repeal and replace" the Affordable Care Act. Some physicians who objected to the amount of reporting required consider the change of political regime a reason to hold off.

That's despite the fact that Merit-Based Payment Incentive System (MIPS) and MACRA reporting begins officially in January 2017. In addition, Andy Slavitt, acting director of the Centers for Medicare & Medicaid Services (CMS), had made the reporting easy for the first year by implementing "pick your pace" reporting—meaning that if physicians reported any measures, it would count.

At a MACRA/MIPS summit held in Washington DC, in December 2016, healthcare policy experts sounded off about the future of MACRA. Most believe it will remain in place; many feel that changes may not be substantial. How big a gamble are doctors taking if they don't move forward with quality reporting and other required reporting?

"Even if MACRA gets tweaked along the way, don't hold your breath waiting for it to go away or be delayed," says Anne Phelps, who served in the Bush Administration as the chief health policy advisor and is now a principal and US healthcare regulatory leader at Deloitte & Touche LLP. "MACRA is different from the Affordable Care Act (ACA) because it had almost equal support by both parties. You do need to keep moving ahead.

"How often have you heard president-elect Trump mention MACRA?" asks Phelps. "Probably never."

Michael Leavitt, chairman of Leavitt Partners, a healthcare consulting firm in Salt Lake City, Utah, and former HHS Secretary under George W. Bush, asked, "What happens now? We have an incoming government that feels a mandate for change."

"This is the strongest signal for change I've seen in my lifetime," says Leavitt. "Republicans have said we are going to repeal and replace. But the only thing certain about that movement is that the title will be 'repeal and replace'; what will actually be on that list is very much up in the air."

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