Steven Lash Shared Views on MACRA Rules

steven lash

Providers are pushing back against the proposed codes to identify which clinicians provide services as promulgated in the draft MACRA rules. The codes are a key component of the payment reform, since they will be utilized to compare resource utilization and outcomes.

Industry leaders say the proposed patient relationship codes, which were mandated by the Medicare Access and CHIP Re-authorization Act (MACRA) of 2015, would be a significant cost and reporting burden.  They further go on to say at the end of the day wouldn’t accomplish the goal of effectively measuring resource use.These codes, which are required to be used by providers who participate in a MIPS, determine the level of responsibility and the costs.

In April, the CMS revealed the 3 patient relationship areas:

  • Continuing or ongoing care
  • Acute care
  • Acute care or continuing care

The proposed codes purpose is to identify what care is provided by a PCP (primary care physician), which provider is providing continuing specialized chronic care services to the Medicare beneficiary, and what physician is coordinating the care process in any acute episode.More Info Steven Lash.