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The MACRA Proposed Rule: The Administration (Largely) Takes a Pass on Medicare Reform (August 4th)
In late June the administration released its 2018 proposed MACRA (Medicare Access and CHIP Reauthorization Act) rule. The largest proposed change is to, again, exclude approximately two-thirds of Medicare (Part B) physicians and other eligible clinicians (ECs) from having to participate in MACRA's Merit-based Incentive Payment System (MIPS) that financially rewards or punishes ECs for performance based on quality measures, improvement activities and health information technology use. This performance year, 2017, over 800,000 ECs are excluded and the administration, namely CMS, is proposing to exclude over 900,000 ECs from MIPS in performance year 2018. Why this is a problem for those excluded, for those included and for Medicare beneficiaries as well is discussed in my essay, "The Many Problems with Medicare's MIPS Exclusion Threshold," posted yesterday on the Health Affairs blog.