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A Conversation on MACRA with a Family Physician

A Conversation on MACRA with a Family Physician

KrisEmily McCrory is a family medicine physician who teaches and practices at Ellis Medicine, a 438-bed teaching health system in upstate New York. In addition to teaching and mentoring residents, seeing patients, and parenting her three children, she is active in physician advocacy and is a member of her state chapter of the American Academy of Family Physicians. McCrory also blogs regularly for Practice Notes, an online blog on PhysiciansPractice.com, about the continuing challenges of dealing with government regulations and what it means to be a physician in today's environment. (You can read her blogs at bit.ly/krisemily-blogs.)

McCrory recently attended the AAFP's 2016 Annual Chapter Leader Forum in Kansas City, Mo., where AAFP president Wanda Filer gave a brief response to CMS' recently released proposed rule on the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA).

Physicians Practice spoke with McCrory about her initial reaction to the proposed rule and how she envisions her own role in meeting MACRA regulations. Below are excerpts of part one of this conversation.

Physicians Practice: Can you tell me about the AAFP national conference that you attended?

KrisEmily McCrory: So the conference that I attended wasn't specifically about MACRA, but the American Academy of Family Physicians (AAFP) has this national meeting every year. It is basically a conference of constituency leaders. … The current president, Wanda Filer of the AAFP, gave a short address about MACRA at this conference that was actually streamed on the AAFP website. … The AAFP, along with some of the other groups as well, is really trying to spearhead education particularly for family physicians about what MACRA is, what they are trying to do. Although MACRA was passed back in April of 2015, the reality is it is not completely done yet. So some of the guidelines, some of the metrics are still being figured out. There is still some time for the different professional societies to continue to kind of weigh in, and obviously the Academy of Family Physicians is doing it on behalf of primary care and family doctors.

PP: What was the AAFP's initial reaction to the proposed rule?

KM: I think that the thought process that has been set up by Wanda Filer, acting on behalf of the AAFP, is that there is great opportunity here to really take some challenging things that came out of meaningful use and things that were related to the previous legislation and make it more flexible and possible for doctors to provide quality care, without feeling like they are overburdened with checking a bunch of check boxes. That being said, because it is not completely finalized yet, it is still just an opportunity. We don't know in the long run that it will really do what they are hoping it's going to do. The Academy is really putting forward a very optimistic face right now, but I can tell you just based on comments (there's a lot of comments on the AAFP website) … family physicians are very concerned about MACRA, the requirements, what they may or may not be, how they are getting paid. A lot of people are very concerned about this whole idea about a value-based payment system and moving away from fee for care, and [wondering] how is this any different from the HMOs that we did with capitation in the 90s that failed miserably. So there are a lot of things that are concerning to family doctors.

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