CMS needs a translator to demystify MACRA models

The CMS and physicians aren’t communicating well on what’s required under MACRA. So the agency is looking for a contractor that can help.

The agency is in the early stages of finding a new contractor to help providers better understand value-based pay models and how they are performing. The third-party company would develop policy around the Quality Payment Program to make it easier to comply with.

Providers in the Quality Payment Program can take one of two pathways for Medicare reimbursement: the Merit-based Incentive Payment System or the Advanced Alternative Payment Models.

Understanding both pathways is critical. If a provider performs poorly under either, it will face financial penalties. By 2021, the CMS estimates that up to...