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The new Medicare system for reimbursing providers outlined in the Medicare Access and CHIP Reauthorization Act, or MACRA, may not adequately reward good performance for those providers dealing with residents and patients needing long-term or end-of-life care, according to a report in Modern Healthcare.

While most providers and advocates praised the new language’s move toward value-based payment, MACRA also has been criticized as unsustainable for small and rural practices and for other reasons. “The quality metrics in the Merit-based Incentive Payment System do not reflect what is often the best course of treatment for the elderly and those with chronic diseases. For example, the number of screenings don’t necessarily reflect the priorities of a person with multiple chronic conditions,” according to remarks made by Joanne Lynn, director of Altarum’s Center for Eldercare and Advanced Illness. She added that the metrics also don’t truly encourage providers to get out into their communities or to ensure older adults are having basic needs met.

Andrew Scholnick with AARP’s Federal Health and Family Team told Modern Healthcare that MACRA needs to ensure there’s a process for evaluating and updating the measures so that the measure set for payments reflects geriatric patients’ unique needs and circumstances.


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