ASCO submitted comments to the Centers for Medicare & Medicaid Services (CMS) on the agency’s final rule detailing the Quality Payment Program, which, under the Medicare Access and CHIP Reauthorization Act (MACRA), changes the way physicians are reimbursed for services provided under Medicare Part B.
ASCO commended the CMS for adding flexibility to MACRA’s implementation and for raising the low-volume threshold—compared with the proposed rule—but urged continued work with the oncology community to address the unique needs of patients with cancer and the mounting administrative burdens facing providers.
The society applauded CMS’s efforts to increase Advanced Alternative Payment Models (APM) participation but urged the CMS to standardize the financial risk criteria for Advanced APMs and other Payer Advanced APMs and to exclude drug costs from the calculation of overall expenditures or revenues at risk in Advanced APMs. ASCO noted that oncologists have little flexibility to reduce overall costs by selecting less costly drugs.
In addition, ASCO urged the CMS to establish criteria and processes for reviewing and implementing recommendations by the Physician Focused Payment Model Technical Advisory Committee (PTAC), an entity established under MACRA to review APM proposals, and to adopt clearer standards so stakeholders have reasonable expectations about the value of pursuing a PTAC recommendation.
ASCO strongly supports value-based reforms to Medicare and has spent the past several years developing new approaches to oncology reimbursement, culminating in the Patient-Centered Oncology Payment Model—an alternative approach to oncology reimbursement that is distinct from CMS’s Oncology Care Model. The Society believes that evaluating proposals and introducing new payment models into the Medicare program are crucial to improving the quality and value of care.
ASCO remains committed to continuing its work with the CMS to implement MACRA in a way that promotes high-quality, high-value care for patients with cancer. To review the complete version of ASCO’s comments on the final MACRA rule, visit www.asco.org/macra. ■
© 2017. American Society of Clinical Oncology. All rights reserved.