MACRA Legislation (Medicare Access and CHIP Reauthorization Act) and the Quality Provider Payment Program: Policy Analysis and Educational Program Evaluation

ABSTRACT Goal: The goal of this Service Learning/Capstone Experience is to provide an in-depth policy analysis and interpretation of the 2018 proposed changes in the Quality Payment Plan (QPP) as part of the 2015 MACRA legislation for the purpose of developing organizational training material. Objectives: The key objectives of this project are 1) to complete a policy review of the current and proposed Quality Payment Program legislation from the Centers for Medicare and Medicaid Services (CMS), including June 2017 proposed updates and the November 2017 final rule updates; 2) to gain physician and hospital administrator’s perspective on realized and perceived impact of the ruling; and 3) to develop a robust educational training plan focused on integrating the updated Quality Payment Program into Medtronic’s Health Care Economics’ team, giving them the appropriate tools to facilitate meaningful partnerships with external customers. Methods: Policy analysis of the 2018 changes to CMS’s MACRA legislation will be conducted as a major component of this Service Learning and Capstone Experience. Additionally, the impact of the shift from volume to value measures in physician payment models will be explored through interviews, physician panels and advisory board surveys. The Value Based Health Care Team utilizes educational resources developed in 2015 that support the initial launch of the Quality Payment Program, which will be reviewed in-depth. Using the data obtained from these activities, a needs analysis will be performed to identify key training and education components that will need to be addressed by the Value Based Health Care team. Impact: Medtronic defines value-based health care as “an effort to develop and deploy products, services and integrated solutions that improve patient outcomes per dollar spent in the healthcare system by improving the quality of care and or reducing the associated expense” (Medtronic, 2017). As a major component of this effort, Medtronic has developed strategies to align outcomes with health care delivery and payment systems (Medtronic, 2017). For Medtronic to understand how the impact of the 2018 QPP updates fits into this strategy, it is critical for the health care economics and policy team to have a robust and cohesive educational plan. Interpreting the current legislation, as well as proposed updates will be a key initiative for this team to effectively partner with physicians and hospital administrators