The Centers for Medicare and Medicaid (CMS) is requesting comment on its draft Quality Measurement Development Plan as part of the continuing implementation of the Medicare Access and CHIP Reauthorization Act (MACRA) enacted earlier this year.  MACRA ended the Sustainable Growth Rate (SGR) formula for determining Medicare payments to health care providers and established a Merit-Based Incentive Payment System (MIPS) that, beginning in 2019, will combine existing Medicare quality reporting programs (Physician Quality Reporting System (PQRS), Value-Based Payment Modifier (VM), and Electronic Health Record (EHR) Incentive Program) into a single system of quality reporting and payment.  The legislation also authorizes, beginning in 2019, additional provider payments for participation in Alternative Payment Models (APMs), including patient-centered medical homes, accountable care organizations, and bundled payment models.

CMS has created a useful graphic timeline for MACRA implementation:

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The draft Quality Measure Development Plan is an important foundational step in determining the structure of the MIPS as well as what quality measures will be required for APMs.  The plan focuses on gaps CMS has identified in the quality measure sets currently in use in PQRS, VM, and the EHR Incentive Program and offers recommendations for filling these gaps. Future measure development will prioritize person- and caregiver-centered experience of care, patient-reported outcomes and patient health outcomes, communication and care coordination, and appropriate use of resources across six quality domains:

  1. Clinical Care
  2. Safety
  3. Care Coordination
  4. Patient and Caregiver Experience
  5. Population Health and Prevention
  6. Efficiency and Cost Reduction

In addition, these measures will promote efficient data collection, better ensure provider accountability – individual and shared, and yield publicly reported quality results that consumers can use to make informed health care decisions. The plan describes how CMS will work collaboratively with federal and state partners and private payers to create an aligned set of measures that reduces provider burden.  The plan also describes resources and activities that can contribute to the development of measures applicable to a wide variety of stakeholders.

Comments are due by March 1, 2016 either online or by sending an email to <MACRA-MDP@hsag.com>

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