The Medicare Access and CHIP Reauthorization Act (MACRA) can help drive healthcare toward competing at the level of clinical conditions, improving outcomes while driving down costs, as we explained in the first part of this article. That said, the legislation’s Quality Payment Programs (QPP), especially the Merit-Based Incentive Payments System (MIPS), have been roundly criticized. Industry, government and academia have gone so far as to say that MIPS is failing and should be eliminated. Yet payers and providers have invested in complying with MIPS. What’s the way forward?
Our take is that while the legislation’s details are likely to be adjusted, MACRA is here to stay because its value-based incentive programs reflect the inevitable direction of the healthcare industry. Many payers and providers we work with already are seeing benefits from complying with the legislation. They consider MACRA a framework for helping the industry move toward value-based competition and see their investments in it as positioning them to compete on clinical conditions vs. simple regulatory compliance.