"Where's The Value In MACRA?" (June 24th)

Students of the Medicare program are well aware in late April, CMS dropped its proposed Medicare Access and CHIP Reauthorization Act (MACRA) rule.  Specifically, the rule addresses MACRA Title I.   At 424 Federal Register pages the rule will make considerable changes to how CMS will, beginning in 2019, annually update Medicare Part or physician payments.  For all the Strum and Drang surrounding MACRA and regulatory implementation thereof, the proposed rule represents conventional thinking.  Despite the considerable rhetoric about moving Medicare payments from volume to value, remarkably, value goes undiscussed, i.e., value as the relationship between care outcomes and spending.  If we're serious about "bending the Medicare cost curve" and/or expecting providers to accept downside financial risk via ACOs and other models or CMS demonstrations, we'll not get there by continuing to ignore measuring for value.  

If you're interested please feel free: http://thehealthcareblog.com/blog/2016/06/23/wheres-the-value-in-macra/