White Paper on MACRA: Past, Present and Future

Area of Science:

• Healthcare policy and economics
• Urological surgery quality improvement

Background:

• U.S. healthcare spending is high, necessitating reforms.
• The Medicare Access and CHIP Reauthorization Act (MACRA) was enacted in 2015 to address quality and cost.
• Physicians need to prepare for MACRA compliance, effective from October 2016.

Purpose of the Study:

• To describe the context and components of MACRA.
• To analyze the impact of MACRA on physician practices, particularly in urology.
• To provide guidance for compliance with the MACRA final rule.

Main Methods:

• Literature review of quality measures and the MACRA final rule.
• Expert panel consultation on compliance strategies.
• Case studies illustrating MACRA expectations for urologists.

Main Results:

• MACRA's Quality Payment Program includes the Merit-based Incentive Payment System (MIPS) and Alternative Payment Models (APMs).
• Compliance with MACRA offers opportunities for improved reimbursement.
• Advanced APMs may simplify reporting compared to MIPS.

Conclusions:

• Physicians should proactively lead efforts to enhance medical quality and control costs.
• Urologists should collaborate to define relevant quality measures, supported by programs like the AUA Quality Registry.
• Developing bundled payment models in urology could qualify for Advanced APM status.