As president of the American Academy of Sleep Medicine, I am keenly aware of the challenges you face in collecting fair reimbursement for the services you provide. Forthcoming changes, including the MACRA transition, will present new challenges for all physicians.
Over the next few years, we will experience a shift from the current fee-for-service payment model toward a model in which payment is based on performance. The AASM is committed to equipping you with the necessary tools to embrace these changes and thrive in the new payment climate.
In April 2015, Congress enacted the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA), repealing the flawed sustainable growth rate (SGR) formula, which had threatened to cause dramatic decreases in payment for more than a decade. MACRA eliminates existing Medicare quality programs (i.e., Physician Quality Reporting System, Value Based Payment Modifier, and EHR Meaningful Use) and replaces them with two new programs: the Merit-Based Incentive Payment System (MIPS) and Alternative Payment Models (APMs).
The reward for successful participation in either MIPS or APMs can be substantial. In contrast, failure to participate will result in significant penalties to future Medicare payments. Reporting requirements for these two new programs will be finalized this fall, and the first performance year begins Jan. 1, 2017. Recently, CMS announced a “pick your pace” option for MACRA that will allow physicians to avoid payment cuts by completing minimal reporting in 2017.
We recognize that the transition to MIPS and APMs is going to be challenging for you. Therefore, the AASM has plans to provide a number of educational resources to help you participate and avoid cuts to payment. These will include a comprehensive overview of deadlines and incentives, fact sheets, and a free webinar in November to review key reporting requirements based on practice type. The Sleep Medicine Trends 2017 course also will include a session about MACRA.
In recent years the AASM has worked to position its members favorably for MACRA through a variety of task force initiatives. These include the publication of the Sleep Telemedicine Implementation Guide, launch of the AASM SleepTM telemedicine platform, and development of the forthcoming Handbook for Optimizing EHR Use in Sleep Medicine, which will be available to members this fall. The AASM Alternative Payment Models Task Force also has developed a proposed bundled payment model for obstructive sleep medicine, which the Academy hopes to test with private payers in the coming year.
The AASM will continue to provide you with more resources related to MACRA regulations. In the meantime, you can submit questions regarding these programs to firstname.lastname@example.org.
Ronald D. Chervin, MD, MS