CMS blasted for nearly 2-year delay in payout of Medicare performance bonuses

Nine organizations are calling on CMS to "expeditiously pay" the 5 percent bonuses to healthcare providers for participation in advanced alternative payment models.

The bonus was established under the 2015 Medicare Access and CHIP Reauthorization Act, which passed Congress with a large bipartisan majority.

It is designed to reward physicians and other clinicians for participating in advanced alternative payment models, such as certain accountable care organizations, and taking on financial risk. But CMS has long delayed the bonuses for performance year 2017, said the nine organizations representing physicians, hospitals, medical group practices, academic medical centers, Medicare accountable care organizations, payers and patients. The organizations expected the bonuses to be distributed in calendar year 2019.

"The up to two-year delay between performance and payment is already significant. We are now nearing the end of the third quarter of 2019, and it is our understanding that no participants have received the expected bonus to date. In contrast, physicians and other clinicians participating in the merit-based incentive payment system [under MACRA] began receiving payment adjustments on Jan. 1, 2019, for their 2017 performance," they wrote in a Sept. 16 letter to CMS Administrator Seema Verma.

"The reason for the holdup is unclear. The delay in payment of the advanced APM bonus unfairly penalizes those that have diligently prepared for MACRA implementation by making investments with the expectation of a 5 percent positive adjustment in 2019," the organizations added.  

Additionally, the organizations told CMS continued delay of the payments could discourage clinicians from participating in risk-bearing payment models or force clinicians "to make difficult budgetary choices in the short term."

They called on the federal government to "expeditiously pay" the bonuses and promise to pay the rewards no later than June 30 of each year.

Organizations signing the letter are American Academy of Family Physicians, American College of Physicians, American Medical Association, American Medical Group Association, America’s Physician Groups, Health Care Transformation Task Force, Medical Group Management Association, National Association of ACOs and Premier.

Read the full letter here.


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