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House Energy and Commerce Committee holds a MACRA/MIPS Reform Hearing
July 5, 2023
On June 22, the House Energy and Commerce Committee, Subcommittee on Oversight and Investigations held a hearing titled “MACRA Checkup: Assessing Implementation and Challenges that Remain for Patients and Doctors.”
Congress passed the Medicare Access and CHIP Reauthorization Act (MACRA) of 2015 to incentivize a shift to quality reimbursement as opposed to quantity or the fee for service payment model. Under the MACRA- Merit Based Incentive Payment System (MIPS), physicians must meet certain quality measures to qualify for reimbursement. MACRA completely eliminated sustainable growth rate (SGR) with a goal of streamlining care for patients and reducing administrative burdens on practices and providers.
The hearing highlighted some of the challenges of the MACRA-MIPS program such as compliance in rural and underserved populations. Chair Griffith (R-VA) cited a 2020 study that “less than 238,000 providers were participating in APMS, while over 933,000 participated in MIPS.” He also mentioned in his opening statement that “MIPS has proven administratively complex to implement and costly for providers.” Chair Rodgers (R-WA) noted “the costs associated with running a medical practice has increased 39 percent and that Medicare payments when adjusted for inflation in practice costs has declined 22 percent from 2001 to 2021.”
Notably, the hearing consensus seemed to be that reform is not likely this year; however SNMMI will continue to provide updates with any changes.
Hearing Witness Panel included: Joe Albanese, Policy Analyst, Paragon Institute; Aisha Pittman, Senior Vice President, National Association of ACOs; Anas Daghestani, M.D., Chair of the Board of America’s Physician Groups, Chief Executive Officer of the Austin Regional Clinic in Texas; J. Michael McWilliams M.D., PhD, Warren Alpert Foundation Professor of Health Care Policy Professor of Medicine Dept. of Health Care Policy, Harvard Medical School.
To view the hearing, you can do so here.