MACRA Implementation: Aurora’s Dr. Bailet Testifies Before Congress

April 22, 2016

On April 19, Jeffrey Bailet, MD, executive vice president, Aurora Health Care, and co-president, Aurora Health Care Medical Group, testified before the U.S. House Energy & Commerce Committee’s Subcommittee on Health at the hearing on Medicare Access and CHIP Reauthorization Act (MACRA) of 2015: Examining Physician Efforts to Prepare for Medicare Payment Reforms. Bailet was one of four physicians invited to testify before the Committee with respect to progress toward the new physician reimbursement system. Bailet currently serves as chair of the MACRA-created Physician-Focused Payment Model Technical Advisory Committee (PTAC). MACRA was enacted in 2015 and replaced the much-maligned sustainable growth rate (SGR). 

During his testimony, Bailet said, “With the enactment of MACRA, physicians and the larger health care community recognize and are preparing for a Medicare payment system that is transitioning away from an unsustainable fee-for-service model based on the volume and intensity of services provided, to one that is value-based, patient-centered and accountable.”

While expressing optimism and even excitement at these changes, he went on to provide a caution with respect to the large-scale shift such changes will mean. 

“Aurora and like-minded medical groups, physician practices and health systems appreciate that this transformation of care delivery is pressing both to enhance the quality of patient care and to address the financial challenges inherent in our current volume-based system. It is equally important, however, that regulators appreciate the need to proceed cautiously during this transition,” he said. 

Elaborating on these large-scale shifts, Bailet said, “Many physicians are in various stages of readiness for a value-based payment system…When implementing the regulations for MACRA’s payment systems, whether it is for the Merit-Based Incentive Payment System (MIPS) or an Alternative Payment Model, CMS should recognize that the health care system will need time to adapt and learn how to function in this new payment environment. Providing an incremental approach that includes flexibility and rational exposure to financial risk will be vital in ensuring a successful transition to value-based payment.”

The Wisconsin Hospital Association (WHA) supports this approach to building out the MACRA reimbursement approach. WHA has long advocated for value-based payments in Medicare, has consistently supported repeal of SGR and supported its replacement, MACRA. To date, WHA has prepared multiple comment letters to the Centers for Medicare & Medicaid Services (CMS) on various aspects of MACRA. 

“For years the Wisconsin Hospital Association, Wisconsin hospitals, health systems and other stakeholders have all supported moving toward a reimbursement model that pays for value, not volume,” said WHA President/CEO Eric Borgerding. “MACRA is one of the largest efforts to move physician payments in that direction. With some 80 percent of physicians employed in Wisconsin by our hospitals and health systems, WHA is keenly engaged in MACRA’s implementation. We are grateful that Dr. Bailet is able to represent those high-value providers nationally through his work with PTAC.” 

During the hearing, Dr. Bailet was asked by U.S. Rep. Larry Buschon (IN), a physician who completed his residency at the Medical College of Wisconsin, about PTAC and the role it will play with respect to Alternative Payment Models. Bailet told the Committee the PTAC will have its second meeting in May and the committee is getting to know one another and diving deeper into specifics of MACRA. 

“This Committee needs to work at a high level,” said Bailet. “We want a transparent process,” he said, with a goal of making sure PTAC’s recommendations are trusted and acted upon by CMS. 

Access Bailet’s full testimony online at: http://docs.house.gov/meetings/IF/IF14/20160419/104813/HHRG-114-IF14-Wstate-BailetJ-20160419.pdf.
 

This story originally appeared in the April 22, 2016 edition of WHA Newsletter