and advocacy will turn to a number of key areas outlined in The Physicians Foundation’s “Medicare Watch List.” Topping the list are long-term
payment adequacy and factors used to calculate performance-based pay- ment adjustments. From 2020 to 2025, there is no update to fee-for-service payments, “and that’s no good,” Dr. Valenti said. He points to an April finding by
CMS’ own chief actuary that while MACRA “eliminate(s) the signifi- cant and immediate problems with the current SGR formula approach,” expiring bonus payments and fixed payment updates “do not vary based on economic conditions, nor are they expected to keep pace with the aver- age rate of physician cost increases.” The memo also expresses concern over the government’s assumptions that APM participation will increase, when more physicians could choose MIPS, and how that ratio will impact future payment adequacy and access to care. Read the full memo at tma
.tips/1OxGvHa. Meanwhile, “committees are being
formed, and we will want to have in- put on those,” such as a technical advi- sory committee on physician-focused payment models, Dr. Valenti said.
“One of the caveats here is, in value- based models, practices have to take into account risk. These models could be saving money, but that assumes ev- erybody has the same patients, when some practices have very high-risk or noncompliant patients. “And a lot of physicians don’t real-
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ize that Medicare data are going to be able to be bought and sold and used,” Dr. Valenti warns. “These are all areas where rulemaking is going to be very important. These issues are very real. Physicians have to be aware of them and act on them. And medicine needs to put forth its best and brightest. Our job is not done.” n
Amy Lynn Sorrel is associate editor of Texas Medi- cine. You can reach her by phone at (800) 880- 1300, ext. 1392, or (512) 370-1392; by fax at (512) 370-1629; or by email at
amy.sorrel@
texmed.org.
62 TEXAS MEDICINE September 2015
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