The Centers for Medicare and Medicaid Services (CMS) awarded $20 million to 11 organizations for the first year of a five-year program to provide training and education about the Quality Payment Program (QPP) for clinicians in individual or small group practices of 15 or fewer. CMS will award a total of $100 million over the five years.

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The AMA supported this technical assistance when the Medicare Access and CHIP Reauthorization Act (MACRA) was being drafted and has been urging the administration to award these funds. For no charge, awardees will assist practices with the following types of activities:

  • Conveying expectations and timelines for the Merit-based Incentive Payment System (MIPS)
  • Explaining the MIPS feedback report
  • Creating a MIPS-score improvement plan
  • Evaluating practice readiness
  • Assessing and optimizing health information technology
  • Supporting change management and strategic planning
  • Developing and disseminating education and training materials
  • Enabling peer-to-peer learning
  • Monitoring clinician success and satisfaction

CMS issued a press release to provide more information.

In comments on the Substance Abuse and Mental Health Services Administration (SAMHSA) draft strategy to prevent and treat opioid use disorder in pregnant women and its postpartum impact on families, as required by the "Protecting Our Infants Act," the AMA stated its strong agreement with the SAMHSA report's focus on the need to overcome prejudice against pregnant women and mothers with substance use disorders.

The AMA's comments (PDF) stressed that pregnant women and mothers with substance use disorders often cannot find a safe environment to seek treatment for pain and/or addiction, and urged that education and awareness campaigns focus on opportunities to treat pain, not just substance use disorders. The same types of barriers, such as coverage limits and prior-authorization requirements that impede access to addiction treatment also limit access to non-opioid and non-pharmacologic treatments for pain.

The AMA is also encouraged by the strategy's focus on achieving healthy families and examining the consequences of removing children from their parents due to prenatal substance exposure.

The Physician-focused Payment Models Technical Advisory Committee (PTAC) has now received five proposals for review and has scheduled four days of meetings in March and April to discuss and consider recommending these proposals to the U.S. Department of Health and Human Services (HHS) for implementation.

The American College of Surgeons submitted a proposal for an episode-based model that reflects input and review of the clinical content of the episodes by many different specialties. The SonarMD model for management of patients with Crohn's disease, utilizing a care pathway and clinical decision tool developed by the American Gastroenterological Association, has already been implemented in 20 medical practices.

In addition, a model focusing on colorectal cancer screening, diagnosis and surveillance was submitted by the Digestive Health Network. The most recent proposal submitted is for treatment of patients with advanced illness and includes care management, team-based care, concurrent curative and palliative treatment, advance care planning and shared decision making.

More information on these proposals is available on HHS' website.

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