Two Years In, Senate Finance Committee Looks at Key MACRA Recommendations

May 10, 2019

ASCO recently submitted comments to the Senate Finance Committee hearing, “Medicare Physician Payment Reform After Two Years: Examining MACRA Implementation and the Road Ahead.” The society’s comments focus on ASCO’s efforts to help members implement provisions of the Medicare Access and CHIP Reauthorization Act (MACRA) in their practices and offered ideas for how Congress and the Centers for Medicare & Medicaid Services (CMS) can strengthen MACRA and the Medicare program in the years ahead.

ASCO’s recommendations to the committee include:

  • Encourage the creation of value-based incentives that increase quality and lower cost –ASCO supports payment models that align physician reimbursement with the full scope of services needed by patients with cancer to promote high-quality, high-value care.  
  • Adopt the Patient-Centered Oncology Payment Model (PCOP) – ASCO’s alternative payment model (APM), PCOP, uses evidence-based clinical pathways as a foundation for rewarding high-quality, high-value care.  
  • Test Multiple Oncology-focused Alternative Payment Models – A “one-size-fits-all” approach to physician reimbursement fails to account for the varied needs of cancer populations and the strength of having different oncology practice structures.
  • Exclude Medicare Drug Cost from Resource Use in Cancer Care – CMS should account for the different circumstances beneficiaries with cancer may face without threatening the viability of subspecialties that focus on treating particularly complex cancers.
  • Promote Interoperability – In ASCO’s view, seamlessly and securely integrating health information is key to improving the quality of cancer care.  
  • Encourage Adoption of High-Quality Clinical Pathways – Using clinical pathways in an oncology-based reimbursement model can improve the quality, efficiency, and value of care and would align Medicare policy with pathway initiatives in use by commercial payers.
  • Improve Access to Claims Data - MACRA required CMS to make its claims data easier to access, but the current process is burdensome and therefore limits access. Congress is urged to work with CMS to ease access to CMS claims data as intended by MACRA.

“Since its enactment, ASCO has educated its members on MACRA and how to make it work for both their practices and the Medicare beneficiaries they serve,” said ASCO President Monica M. Bertagnolli, MD, FACS, FASCO, in the comments. “We appreciate the committee’s shared commitment to MACRA’s success.”

Read the full comment letter.

ASCO supported MACRA’s passage as a replacement for the flawed and unpredictable Sustainable Growth Rate formula. The society has since developed an extensive online toolkit with MACRA-related practice tools, webinars, and other readily available resources.

Visit ASCO in Action for updates on MACRA implementation and other breaking cancer policy news.