Slavitt Offers Value-Based Care Steps Post MACRA Implementation

December 05, 2016 - As CMS gets ready for MACRA implementation in the new year, CMS Acting Administrator Andy Slavitt urged healthcare and political leaders to carry on value-based care progress made under the Affordable Care Act.

In a statement at the MACRA MIPS/APM Summit in Washington, DC on Dec. 1, Slavitt suggested that the healthcare industry continue value-based care progress after MACRA implementation by promoting universal healthcare coverage, supporting the CMS Innovation Center, developing interoperable health IT, and focusing on patient-center care.

“In fact, there hasn’t been a greater stretch of progress in our nation’s history as measured by the amount of positive change that has impacted people and their lives and our path to a sustainable future as in the last 8 years,” said Slavitt. “But this progress should only be the start if we are to fulfill the real promise of caring for people in our country and doing it in a way that reduces the overall burden of the healthcare system.”

Slavitt first called on leaders to “not head backwards” by losing sight of a universal coverage goal. With 20 million individuals now covered by a health plan under the Affordable Care Act, he urged leaders to build on this success by providing more comprehensive coverage, including no-cost preventative care, removing lifetime and annual coverage limits, and eliminating pre-existing condition exclusions.

The value-based care transition depends on universal coverage, Slavitt added, because limiting patient access to high quality, affordable care will only drive up long-term healthcare costs.

“There can be no delivery system reform without building on the foundation of reaching universal coverage,” Slavitt said.

Supporting the CMS Innovation Center will also ensure successful MACRA implementation and further the value-based care transition, Slavitt stated.

“I’ll say this bluntly: MACRA can’t work as well without a CMS Innovation Center that can move quickly to develop and expand new approaches to paying for care,” he said.

At the Innovation Center, CMS develops alternative payment models, including those that qualify as Advanced Alternative Payment Models and could earn eligible clinicians value-based incentive payments under the Quality Payment Program.

Slavitt touted that the center, which was created under the Affordable Care Act, has developed over 30 alternative payment models and programs. The Congressional Budget Office also projected the center’s initiatives to reduce federal spending by $34 billion over the next decade.

However, changes to the federal agency’s center could stop the development of new alternative payment models, Slavitt stated.

“We will have a much narrower path with fewer specialty options and approaches, which take in patient and physician feedback,” he said. “Medicare and commercial payers would then fall further out of alignment, and more importantly, less patients would have access to innovative care methods.”

In addition, Slavitt advised healthcare leaders to demand health IT that is interoperable, value-based, and affordable to further support MACRA implementation. CMS designed MACRA to reduce administrative and reporting burdens for providers, so health IT, including EHRs, should support the agency-wide goal.

“The technology community must be held accountable by their customers and make room for new innovators and to give clinicians more freedom and more flexibility to focus on their patients, to practice medicine, and deliver better care,” stated Slavitt.

The future of healthcare policies should also continue on a path to patient-centered care, Slavitt continued. Potential policies and healthcare reform should put patients at the center of care and pay providers based on outcomes and patient satisfaction, like MACRA intends to do.

“Don’t forget that people are the heart of every policy made,” said Slavitt. “We are on a journey as a nation towards better health for all. Patients. Care givers. Consumers. You know them better than anyone because you care for them. View MACRA as a step in the journey to develop care together.”

Additionally, Slavitt warned healthcare leaders that MACRA was not intended to “implement a new scorekeeping system.” He urged healthcare leaders and policymakers to keep listening to providers, patients, and other stakeholders to continue improving the Quality Payment Program.

He noted that CMS has already started to improve the value-based reimbursement initiative by listening to stakeholder feedback and making appropriate changes, such as flexible MACRA attestation tracks in 2017, more Advanced Alternative Payment Model options, and simplified quality reporting.

“As we move forward, we all need to keep building on what works while systematically demanding improvement where we can do better,” Slavitt said.

Dig Deeper:

• CMS Timelines for Stage 3 Meaningful Use, MACRA Implementation

• What We Know About Value-Based Care Under MACRA, MIPS, APMs