Academy urges CMS to suspend MU Stage 3 and slow APM approach

Kathryn SchwarzenbergerBy Kathryn Schwarzenberger, MD

When the Medicare Access and CHIP Reauthorization Act was signed in 2015 (MACRA), the sustainable growth rate (SGR) formula was finally repealed. This law ended a 13-year fight against massive cuts to Medicare physician payments, and stopped a debilitating CMS proposal that would have eliminated global period codes. 

This was an incredible win for our patients and the specialty, and it did not come about by chance. Strong work by the Academy’s advocacy team in Washington, D.C., and active participation by many of our Academy members helped make these advocacy achievements possible. During the debate on SGR repeal and Medicare payment reform, our Washington, D.C. office sent countless emails encouraging Academy members to write Congress in support of the legislation through the Academy’s Dermatology Advocacy Network. As a result, Academy members sent a record-breaking 5,000 emails to their members of Congress supporting the legislation. 

While the repeal and replacement of the SGR formula is a big win, it is certainly not perfect. Our advocacy staff, along with Academy members on relevant committees, including the Workgroup on Innovation in Payment and Delivery, is working diligently to monitor the implementation of MACRA and ensure that the needs of our specialty, as well as those of our patients, are taken into account as the government moves forward with health care reform.

Earlier this month, the Academy submitted a statement for the record to the U.S. House Energy and Commerce Subcommittee on Health, which held a hearing on the implementation on Medicare payment reforms on March 17. In the letter, the Academy focused comments on concerns related to the changing payment environment.

The letter stressed that dermatologists understand the importance of participating in alternative payment models (APMs), and have begun exploring the feasibility and applicability of various alternative payment models for select dermatologic conditions. As CMS moves forward with MACRA implementation, the Academy urged the agency to:

  • Commit to a gradual, phased-in approach to the Merit-Based Incentive Payment System (MIPS) and APM provisions in MACRA, recognizing the unique challenges that specialty care, including dermatology, may experience when attempting to participate in these programs. This will bring the new physician payment framework closer to its intended goals of rewarding quality care, ensuring patient access, and creating an efficient health care system. 
  • Preserve the viability of fee-for-service as a payment model.  
  • Create a more meaningful and less unduly burdensome Meaningful Use (MU) program, and put a hold on new or heightened MU Stage 3 requirements. 

We will continue to monitor the changing health care landscape and respond on behalf of all our members. I encourage everyone to read the Academy's statement for the record in its entirety and to support the Academy’s advocacy efforts as we work closely with legislators to ensure that physician practices are ready for MACRA. 

Dr. Schwarzenberger is the chair of the Academy’s Workgroup on Innovation in Payment and Delivery.