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    AACU on MACRA: Delay rollout, adjust low-volume threshold

    Based on a partnership with Urology Times, articles from the American Association of Clinical Urologists (AACU) provide updates on legislative processes and issues affecting urologists. We welcome your comments and suggestions. Contact the AACU government affairs office at 847-517-1050 or [email protected] for more information.


    The American Association of Clinical Urologists (AACU) submitted comments on the post-SGR Medicare reimbursement program, MACRA, on June 27, 2016. In its comments to the Centers for Medicare & Medicaid Services (CMS), the AACU expressed concern over a number of provisions that stand to negatively affect urologists in their practice of medicine and increase the cost of medical care.

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    The AACU strongly opposed the program's aggressive implementation schedule. As currently envisioned, CMS will measure providers' performance beginning Jan. 1, 2017. This timeline does not allow ample time for physicians and other stakeholders to adequately prepare for the changes brought on by these new policies. While the flexibility of choice between alternative payment models (APM) and the Merit-Based Incentive Payment System (MIPS) is a positive change, this choice is fraught with complexity.

    The administrative burden associated with the new requirements is prohibitive on many levels, including financial and human resource costs. The hurried pace will no doubt lead to unintentional mistakes, as well as expensive and onerous appeals.

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    To add further burden to MACRA implementation, both the APM and MIPS programs require the use of electronic health record (EHR) technology by all providers beginning in 2018. While the intent of this requirement may be to enhance health care delivery, the AACU envisions the opposite effect. Under current, less stringent requirements, many providers and hospitals struggle with EHR adoption. Many physicians view EHRs as a barrier to treating patients and an ever-increasing overhead cost.

    Next: "The complex issue of EHR liability is also left unaddressed in the proposed rule"

    Julia Norwich
    Julia Norwich is associate director of the American Association of Clinical Urologists.


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