NCQA Policy Team Responds to MACRA Final Rule Release

Thought you might want to see behind the scenes. The world of health policies is in turmoil over the publication of the MACRA Final Rule by the Centers for Medicare & Medicaid Services (CMS) this morning. Our public policy experts continue to analyze the 2,400 pages of the rule. Here is the press release sharing our initial reaction. This is posted on our website, but for convenience we decided to post it here too. It's a little small. The text is below …

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Matt Brock, 202-955-1739

Cindy Peña, 202-735-3690

Press Release


The final rule is published, the NCQA policy experts team available for interviews

WASHINGTON, DC – The team of NCQA policy experts has dissected the details in MACRA's final rule since its release this morning. Here is our reaction and our early response.

"NCQA congratulates CMS for maintaining its support for NCQA Medical-Centered Medical Homes (PCMH) and Patient-Centered Specialized Practices (PCSP)," said NCQA Federal Affairs Director Paul Cotton. "Patient-centered care is the key to success for clinicians in all categories that MACRA will measure and use to adjust payments."

As a measure developer, NCQA is disappointed with relaxed reporting requirements and the lack of rigorous quality measurement criteria.

"We appreciate the need to lighten the initial reporting requirements of this historic move to pay clinicians for value rather than just the volume of care they provide," said Cotton. "However, this will result in a less robust assessment of the quality on which payments are based, and we encourage CMS to revisit and raise the standards for MACRA in future regulations."

Another early reaction

Behavioral Health . We are pleased that MACRA's final rule prioritizes behavioral health by including more behavioral health measures. Behavioral conditions are considerably outsourced and strongly associated with greater use of other health care services and higher costs. If it is not treated, it can cause unnecessary suffering and higher costs for other medical problems. The additional measures included in the final rule will encourage greater coordination of care between behavioral and physical health care providers.
Small Practices . We are encouraged by the CMS provisions that facilitate the burden of small practices. Ensuring the viability of these practices will be critical to protecting access in some parts of the country and ensuring that MACRA works for all clinicians, not just those in more organized systems.
Electronic reports . The final rule includes bonus points for electronic reports. This will encourage our health care system to work toward greater and better results measurement. We hope this will encourage electronic health record providers to create systems that leverage natural clinical workflows to minimize the reporting burden. The success of electronic reporting will depend on the ability of systems to deliver accurate and reliable quality measurement results. We remain concerned about the tools currently available to certify the validity of the measurement results and we encourage you to consider other certifications such as the NCQA eMeasure certification. Industry leaders such as HIMSS and Premier have consistently claimed that NCQA certification is more robust and rigorous than existing NCB processes.

NCQA looks forward to exploring the final rule and working with CMS on other updates. Margaret E. O. Kane, president of the NCQA, issued a statement immediately following the announcement of the final rule.

"NCQA's focus has been on improving the quality of health care for over a quarter of a century, and we know how hard this job is. Helping all physicians and other health care professionals make the transition to value-based care – whether they work alone, in small groups or in integrated health systems – is the challenge of our time, "he said. NCQA President Margaret E. O. Kane.

"The overwhelming majority by which the MACRA spent Congress last year reflects a bipartisan consensus that the way we pay for health care and the way it is organized is unsustainable and must This final rule is an important next step towards achieving this change and we look forward to playing our part in helping make MACRA work for everyone. "

The NCQA team of health care policy experts are eager to answer questions:

Michael S. Barr, MD, MBA, MACP, Executive Vice President, Quality Measurement and Research Group
Frank Micciche, Vice President, Public Policy and Communications
Paul Cotton, Director of Federal Affairs


About NCQA

NCQA is a private non-profit organization dedicated to improving the quality of health care. NCQA accredits and certifies a wide range of health care organizations. It also recognizes clinicians and practices in key performance areas. The NCQA Healthcare Data and Information Set (HEDIS®) is the most widely used performance measurement tool in health care. The NCQA website ( contains information to help consumers, employers and others make more informed health care choices.

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Matt Brock is the Director of Communications at NCQA. After more than two decades in broadcast journalism, Matt now leads NCQA's efforts to develop unique content that engages and informs consumers and suppliers, plans and decision-makers via this blog, our website, and many social media platforms. Matt's goal is to educate consumers and direct them to the best resources when they consider the quality of their healthcare decisions.


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