CMS just released their proposed MACRA regs (Cliff Notes version), and as you could expect, every specialty society and interested party dug in and critiqued. The rule runs a thousand pages and will have a substantial effect on the future of provider payment. In case, you have not heard.
Each organization will cut their sections of interest out, parse them, synthesize their analysis, and return a long letter to CMS. They will offer the correct paths on which the agency should proceed–lest they go forward uninformed taking down entire blocks of the healthcare system on account of willful neglect and ignorance. The letters will start with a friendly salutation along the lines of, “We commend the Secretary on her wisdom and hard work….BUT, we have an eensy weensy problem on some issues,” and so the turn goes.
The inpatient docs will hit the rough patches as they relate to fitting hospital-based practitioners into an outpatient focused model; the nephrologists will sound off on integrating dialysis payments within a medical home; the surgeons will focus on attribution of adverse post-op events weeks after patients leave the hospital; and the pathologists will just throw their hands up and say, “huh, should we just skip this party.”