Internists talk about MACRA and how it will affect physicians and patients

Panel discussion includes challenges and opportunities, impact on patients, and ACP's role in helping practices succeed

(Boston, May 1, 2015)- A summary of the key provisions of the new Medicare Access and CHIP Reauthorization Act (MACRA), H.R. 2 and an explanation of how it will put Medicare on a pathway to "value-based" payments was provided today at a press briefing, "Medicare payment, post-SGR: How will the new law transform how Medicare pays doctors?", during the American College of Physicians (ACP) Internal Medicine Meeting 2015.

The Medicare Access and CHIP Reauthorization Act (MACRA), H.R. 2 was passed overwhelmingly by the House of Representatives on March 26 by a vote of 392 to 37. It was approved by the Senate on April 14 by a vote of 92 to 8, and then signed by the President on April 16.

The summary and explanation were given as part of a panel presentation featuring Bob Doherty, SVP, Governmental Affairs and Public Policy for ACP; Shari Erickson, ACP's vice president, Governmental Affairs and Medical Practice ; and Nitin Damle, MD, MS, FACP, a founding partner in an eight-physician private practice in Wakefield, R.I. and president-elect designee of ACP.

Doherty, who also moderated the session, summarized the legislation and said why ACP supported it. "This legislation earned the support of ACP and more than 750 additional physician-membership organizations. It repeals the Sustainable Growth Rate (SGR), and replaces the SGR's 21percent cut to physicians with stable and positive payment updates for the next four-and-a-half years. Then, starting in 2019, it gives physicians options to earn performance based incentive payments, either by participating in a new Merit-based Incentive Payment System or as an Alternative Payment Model, like a Patient-Centered Medical Home. Doherty said. A more detailed description of the law, compared to ACP policy, can be found at

Erickson talked about the next steps for advocacy on the legislation. She focused on what ACP will be doing to ensure that it is implemented effectively and that there is proper preparation for the 141,000 ACP members. She also described efforts to be certain the right tools for measurement will be used.

"Moving forward, ACP will be very engaged in influencing CMS on implementation of the law, to ensure it stays true to its intent of significantly improving the Medicare physician payment system. Additionally, ACP will make it our top priority to ensure that our members are fully informed about and prepared for active and successful participation in the newly established Merit-based Incentive Payment System or an Alternative Payment Model," Erickson said.

Dr. Damle addressed the legislation's elimination of the SGR formula as being especially important to patients because it provides sustained and undisrupted access to care. "For the past 12 years, physicians and patients have had to deal with the uncertainty of participation in the Medicare and Medicaid program due to potentially unsustainable cuts in payments. Now patients need not worry about the loss of their physician or the continuity of care."

Dr. Damle pointed out that "the repeal of the SGR provides a more secure environment for physicians to expand and invest in their practices to improve care and lower costs. The movement to more quality and cost-based payment requires a significant shift in the practice of medicine, with continued adoption of the Patient Centered Medical Home model, performance measurement and reporting and accountability for costs. Physicians can now make choices between the Merit Based Incentive Payment System and risk sharing through an Accountable Care Organization. These payment models offer opportunities for significant improvement in the quality of care and improved reimbursement to primary care physicians."

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The American College of Physicians is the largest medical specialty organization and the second-largest physician group in the United States. ACP members include 141,000 internal medicine physicians (internists), related subspecialists, and medical students. Internal medicine physicians are specialists who apply scientific knowledge and clinical expertise to the diagnosis, treatment, and compassionate care of adults across the spectrum from health to complex illness. Follow ACP on Twitter and Facebook.