The National Committee for Quality Assurance (NCQA) has published this discussion paper in response to the implementation of the Medicare Access and CHIP Reauthorization Act (MACRA), which will fundamentally change Medicare payments to physicians beginning as early as 2019. MACRA includes a Merit-Based Incentive Payment System (MIPS) that will adjust fee-for-service (FFS) payments based on performance. MACRA also encourages clinicians to develop and participate in Alternative Payment Models (APMs) that move toward greater compensation for value instead of volume. NCQA paper suggests for discussion potential principles for achieving that optimal future state:
- Principle A: Every Medicare enrollee needs a dedicated and well-organized primary care team.
- Principle B: Measurement must be specified appropriately for each different unit of accountability.
- Principle C: Measurement should support rapid improvement and clinical decision making.
- Principle D: A core set of measures will let all stakeholders make comparisons across programs.
- Principle E: Quality measure results should be easy for consumers and payers to get and use.
NCQA invites comments on its discussion paper on its website.
The Centers for Medicare and Medicaid Services has issued a Request for Information seeking pre-rulemaking comments on MACRA implementation, with comments due on November 2, 2015.