Member Forum

You can comment on Medicare payment policy for 2018- proposed changes

  • 1.  You can comment on Medicare payment policy for 2018- proposed changes

    Posted 07-16-2017 14:46
    Once again, CMS is proposing changes in how they pay for MCR, mostly FFS.
    If there's any way they could make your life easier, here's the chance to tell them.
    The Rule won't be open for comment until July 21.
    You can find it by searching for "CMS-1676-P" at

    "CMS is seeking comment from stakeholders on specific changes we should undertake to update the guidelines, to reduce the associated burden, and to better align E/M coding and documentation with the current practice of medicine. We are especially seeking comment on how we might focus on initial changes to the guidelines for history and exam, because we believe documentation for these elements may be more significantly outdated."

    In other words, they're going to change the documentation standards for E&M visits, so you'll have a whole NEW set of rules to follow to get paid!

    We would like to start a national conversation about improving the healthcare delivery system; how Medicare can contribute to making the delivery system less bureaucratic and complex; and how we can reduce burden for clinicians, providers, and patients in a way that increases quality of care and decreases costs, thereby making the healthcare system more effective, simple, and accessible while maintaining program integrity and preventing fraud.

    CMS is soliciting ideas for regulatory, sub-regulatory, policy, practice, and procedural changes to better accomplish these goals. Ideas could include recommendations regarding payment system re-design; elimination or streamlining of reporting; monitoring and documentation requirements; operational flexibility; and feedback mechanisms and data sharing that would enhance patient care, support the doctor-patient relationship in care delivery, and facilitate patient-centered care. Ideas could also include recommendations regarding when and how CMS issues regulations and policies and how CMS can simplify rules and policies for beneficiaries, clinicians, providers, and suppliers.

    My personal opinion is they're solving the wrong problem.  Until they increase the supply of comprehensive primary care and fix the problem of maldistribution, (by paying fairly for comprehensive primary care and rural care,) they CAN'T improve care.  They're pretending that creating tiny incentives, will can get what they want (comprehensive primary care) without paying for it.  Simply delusional.

    Implementing the AAFP APM would be a start; implementing it with HowsYourHealth as the quality measure instead of MIPs, IMO,  would be even better.  That would be similar to Jean Antonucci's $3/day scheme, but with more complex risk adjustment.

    What do YOU folks think would be the best way to start fixing the health care financing system?

    Peter Liepmann MD FAAFP MBA
    My mission is to fix US health care
    Bakersfield CA