When the Sustainable Growth Rate formula finally went into effect, it quickly proved to be unsustainable. Congress issued too many “doc fixes” year after year, despite early advice from the Medicare Payment Advisory Commission. But a decade of these temporary measures (“doc fixes”) did not actually fix the flaws intrinsic to SGR.
Fast-forward to April of this year: CMS issued a Notice of Proposed Rulemaking to put the components of the Medicare Access and CHIP Reauthorization Act (MACRA) of 2015 into place. This bipartisan legislation is now a reality and will replace the flawed and problematic Sustainable Growth Rate formula that is now being laid to rest. In theory, MACRA represents a move towards rewarding value and quality in care, over time, as well as a more customizable model that is intended to better suit the specific type of care provided and organization under which qualified professionals operate – but only time will tell. Going forward, Congress will not have to issue any “doc fixes” and the idea is that MACRA should provide a more predictable payment method that incentivizes value.
Stay tuned as we outline a more detailed timeline and break down the many components of MACRA.