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Advocating for CMMI Reform, Looking Ahead to Alternative Payment Models

Carina Stanton  |  May 17, 2017

“These principles will go a long way toward focusing the important work of CMMI on appropriately scaled projects that align Medicare payment structures with our patients’ healthcare needs. The ACR supports fully transparent, innovative, data-driven ways to make healthcare more valuable and accessible to our patients,” noted Angus Worthing, MD, FACR, FACP, chair of the ACR’s Government Affairs Committee in the initial press release.

Mr. Cooper says, “We see that a CMMI that adheres to the principles presented to Secretary Price can be a highly effective and necessary agent in helping successfully navigate the new world of value-based care.”

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Looking to a Reformed Payment Approach
In related reform changes, implementation of the Medicare Access and CHIP Reauthorization Act (MACRA) of 2015 brings an aggressive timeline for a Merit-Based Incentive Payment System (MIPS) that requires rheumatology practices to report on specific quality measures. Under MACRA, a rheumatology practice can also consider operating under Alternative Payment Models (APMs).

Although there is no current APM tailored to fit the work of a rheumatology practice, the ACR is exploring the feasibility of developing a rheumatology-focused APM that would work for ACR members, Mr. Cooper explains. “A reformed CMMI could prove to be a valuable partner in helping the ACR shape and test a rheumatology-specific APM.”

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What You Can Do
As the ACR continues with this policy work to ensure that future reform efforts will still support College members and protect how they practice, every member can be working in their own practice to advance how quality measures are collected and reported, as outlined by the MIPS program under MACRA. One invaluable step: Join the ACR’s Rheumatology Informatics System for Effectiveness (RISE) Registry to allow for automatic collection and reporting of data for MIPS, automatic points toward higher scores and payments, and the collection of quality data to help practices assess how they are doing and where they can improve.

The RISE Registry can also provide data for ACR to use in designing both MIPS quality measures and  an APM for rheumatologists. “The more rheumatologists who sign on to RISE, the more helpful RISE can be in unlocking real-world information about describing and reporting high-quality rheumatologic care. It’s truly a win–win for doctors and patients,” says Dr. Worthing.

Follow ACR@Work to keep up with the ongoing work of the ACR and the AIM coalition’s progress.


Carina Stanton is a freelance science journalist in Denver.

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Filed under:Legislation & AdvocacyProfessional Topics Tagged with:Center for Medicare and Medicaid Innovation (CMMI)Healthcare Leaders for Accountable Innovation in Medicare andpayment models

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