The Department of Health and Human Services has issued a proposal rule to begin the process of linking the cost and quality of patient care for physicians and clinicians.

HHS this afternoon issued a notice of proposed rulemaking as a first step in implementing certain provisions of the Medicare Access and CHHIP Reauthorization Act of 2015 (MACRA).

Bloomberg/file photo

The legislation is intended to replace previous approaches that were intended to regulate the growth of physician payments. The proposed rule would streamline various programs into a unified framework called the Quality Payment Program, which includes two paths—the Merit-based Payment System (MIPS) and Advanced Alternative Payment Models.

As envisioned, most clinicians are expected to participate in the new Quality Payment Program through MIPS. Four components would affect payment, including a category to advance care information, which would affect 25 percent of a physician’s total score in the first year of the program. Other components of the reimbursement formula are quality (50 percent), clinical practice improvement activities (15 percent) and cost (10 percent).

For the category advancing care information, “clinicians would choose to report customizable measures that reflect how they use technology in their day-to-day practice, with a particular emphasis on interoperability and information exchange,” the agency said. “Unlike the existing reporting program, this category would not require all-or-nothing EHR measurement or redundant quality reporting.”

The 962-page proposed rule can be found here.

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