Feds Outlines Challenges in Payment Reform

A new paper developed for the Centers for Medicare & Medicaid Services (CMS) outlines the challenges the government faces in implementing a new approach to physician payment under the Medicare program—scheduled to begin in 2019. Under a law passed earlier this year, CMS is required to develop quality measures in all medical specialties to transition to Medicare Merit-based Incentive Payment System (MIPS) reimbursements for most payments to physicians, as well as to support alternative payment model (APM) reimbursements to a subset of physicians across the U.S. The paper focus on a few key challenges, such as including patients in measure development, reducing data collection burdens for providers, shortening time frames for new measure development, speeding data acquisition in order to test measures, and developing measures that focus on outcomes of care. Additional challenges outlined in the paper include focusing on patient-reported quality measures and on measures that evaluate coordination across settings and provider groups. CMS notes that the new law doesn’t require that measures be submitted for consensus endorsement prior to implementation but does require that measures be submitted for publication in peer-reviewed journals. The draft CMS Quality Measure Development Plan, which was prepared by the Health Services Advisory Group, Inc., is available at www.cms.gov.