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Physicians react to CMS' final MACRA rule — 6 things to know

On Oct. 14, HHS released the final Medicare Access and CHIP Reauthorization Act rule, which aims to help providers succeed under value-based care. While some physicians are applauding CMS' efforts, others say it may not go far enough, according to MedPage Today.

Here are six things to know:

1. Katie Orrico, JD, director of American Association of Neurological Surgeon's Washington office, said CMS listened to physicians about the low-volume threshold. CMS' final rule increased the low-volume threshold to $30,000 in Medicare Part B charges or 100 Medicare patients.

2. However, AANS says CMS underestimated the cost of compliance, with CMS estimates placing cost at nearly $1,200 per physician to create the necessary infrastructure that complies with MACRA. However, Government Accountability Office estimates this figure could actually total $40,000 per physician.

3. AANS also claims CMS is not taking a comprehensive view of managing care. Ms. Orrico said CMS is utilizing a check-box approach, while AANS has implored CMS to "provide full credit to satisfy at least the EHR, quality and clinical practice improvement activities elements of MIPS for those neurosurgeons participating in clinical data registries." The new rule does allow physicians who participate in registries to gain quality and clinical improvement activity credit, but Ms. Orrico said the program does not offer fully integrated support for reporting.

4. American Academy of Family Physicians applauded the new rule. In a prepared statement, John Meigs, Jr., MD, AAFP president, noted the rule addressed many concerns the organization had concerning complexity, pace of implementation, administrative burdens and technological usability. Dr. Meigs noted he was happy with the low-volume exemption and said the exemption allows more physicians to participate without fear of penalty.

5. American Society of Clinical Oncology also stands behind the final rule, especially CMS' move to add 2017 as a transitional period and including the general oncology specialty measure set in the final rule after the agency removed it from the proposed rule.

6. American Osteopathic Association said although it commends CMS for taking measures to broaden participation in the alternative payments models, it is not pleased that many providers in patient-centered medical homes did not quality for APMs and have limited opportunities to engage in value-based models. Don Crane, president and CEO of CAPG, which represents group practices and independent practice associations also was not satisfied that CMS excluded Medicare Advantage models from advanced APMs. Mr. Crane told MedPage Today, "We are committed to working with Congress and CMS to ensure equal consideration of the need for delivery system transformation for Medicare Advantage beneficiaries who now make up nearly a third of the Medicare population."

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