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ACCP Report

Washington Report: ACCP Practice Management Issue Brief: Payment Methods in Outpatient Team-Based Clinical Pharmacy Practice, Part 2—MACRA for Pharmacists

Capitol

John McGlew
Director of Government Affairs

The Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) was established to reform the Medicare fee-for-service (FFS) payment model and create a new value-based payment approach that incentivizes and rewards high-quality patient care under the Quality Payment Program (QPP). The QPP is focused on rewarding the delivery of high-quality patient care through two avenues—the Merit-Based Incentive Payment System (MIPS) and the advanced Alternative Payment Models (advanced APMs).

Under MACRA, beginning in 2019, MIPS-eligible clinicians or group practices will participate in a combined value-based payment program that assesses the performance of each provider according to quality, resource use, clinical practice improvement activities (CPIAs), and meaningful use of certified electronic health record technology. The law also creates incentives for participating in APMs, an approach consistent with its broader goals of moving more FFS payments into APMs that focus on better care, smarter spending, and healthier people.

ACCP recently released a Practice Advancement Issue Brief that explores opportunities for participating practices to integrate pharmacists into team-based care structures. Although pharmacists are not currently listed as MIPS-eligible clinicians, many of the MIPS performance measures are directly related to medication use. MACRA and its impact on transitioning health care to a value-based environment positively incentivizes practices to integrate pharmacists into team-based care structures.

ACCP remains fully committed to its initiative to recognize the direct patient care services of qualified clinical pharmacists as a covered benefit under the Medicare program. The College is confident that its legislative and regulatory proposal is consistent with the overall structure of the MACRA payment approach and will continue to work with its friends and allies on Capitol Hill to integrate coverage for comprehensive medication management services within the evolving Medicare program.

Click here to access the MACRA for Pharmacists Practice Advancement Issue Brief.

For more information on any of ACCP’s advocacy efforts, please contact:

John K. McGlew
Director, Government Affairs
American College of Clinical Pharmacy
1455 Pennsylvania Ave. Northwest
Suite 400
Washington, DC 20004-1017
(202) 621-1820
[email protected]