Question special

Thank you to our expert panelists for their participation and to our authors for their reflections on the recent MACRA legislation. It seems that the answers to what metrics will be used to measure cost and quality will have a major impact on how physicians will stand to benefit or lose in the new program. The new Merit-Based Incentive Payment System (MIPS) has created four categories of measures that are weighted to calculate an overall MIPS score: quality, resource use, clinical improvement and EHR use. Resource use performance measures will supplement existing measures from the VPM program and to my understanding the law leaves for later rule-making decisions on whether total cost will be included as a metric. If you were writing the regulations, what metrics do you think would be most meaningful to include for "Resource Use"? How will risk-adjustment work in order to account for patients who require complex or extended care due to multiple co-morbidities?