Medicare is shifting rapidly to value-based and integrated care. Notably, the Medicare Access & CHIP Reauthorization Act of 2015 (MACRA) initiated major changes in Medicare physician payment. In addition to ending the long reviled Sustainable Growth Rate (SGR) used to update Medicare professionals’ payments, MACRA creates two new value-based programs, which will rely on interoperable health IT (HIT). Payments will be affected by these models starting in 2019 (likely based on 2017 performance).

While a second biosimilar recently being approved in the United States does not a tsunami make, biosimilars are nonetheless expected to quickly become mainstream. In response, stakeholders are beginning to work on how to make them safe and useful within the parameters of today’s healthcare system because, biosimilars – like biologics – are made from living organisms, which makes them very different from today’s conventional drugs.

In Part 1 of this post, I provided an overview of the new Medicare Quality Payment Program (QPP) proposed in response to the 2015 Medicare Access and CHIP Reauthorization Act (MACRA), which sets out a path to value-based Medicare physician payment. The CMS proposed rule implementing MACRA was released April 27; comments are due June 27. In Part 2, I summarize healthcare IT (HIT) implications of the QPP and provide my initial observation on the proposed rule.