CMS says providers can 'pick their pace' for MACRA: 6 things to know

CMS is offering flexibility to providers participating in the Quality Payment Program under the Medicare Access and CHIP Reauthorization Act, outlining multiple options as to how they can participate in the first year.

The Quality Payment Program is set to begin Jan. 1, and for the first performance period — calendar year 2017 — eligible providers can select between four options for participation that would ensure they do not receive a negative payment adjustment in 2019.

Here are six things to know about the proposed rule.

1. The four proposed options offer different levels of participation in the Quality Payment Program in 2017, ranging from submitting "some data" to fully participating in an Advanced Alternative Payment Model. CMS says it wants to allow providers to participate in the program at a speed with which they are comfortable, at least for the first year. "We intend for the Quality Payment Program to allow physicians to pick their pace of participation for the first performance period," Andy Slavitt, acting administrator of CMS, said in a post.

2. The first option allows providers to "test" the Quality Payment Program. If providers submit "some data" to the Quality Payment Program after Jan. 1, they will avoid a negative payment adjustment in 2019.  "This first option is designed to ensure that your system is working and that you are prepared for broader participation in 2018 and 2019 as you learn more," according to the post.

3. The second option permits providers to participate in the program for part of the calendar year. Providers who pursue the second option can submit quality measure and improvement activity data required under the Quality Payment Program for a reduced number of days and still qualify for a small positive payment adjustment.

4. The third option is geared toward organizations ready to fully participate and submit Quality Payment Program information for the full calendar year. Such organizations could qualify for a "modest" positive payment adjustment. "We've seen physician practices of all sizes successfully submit a full year's quality data and expect many will be ready to do so," Mr. Slavitt wrote in the post.

5. Finally, providers can choose to participate in an Advanced Alternative Payment Model in 2017, like a Medicare Shared Savings Program Track 2 or 3 accountable care organization. Providers who are successful in these alternative payment models could qualify for a 5 percent incentive payment in 2019.

6. Mr. Slavitt writes CMS will release the final rule by Nov. 1, and the final rule will contain more details and further address concerns often voiced by providers, such as burdens of excessive reporting, unique issues facing small and rural, non-hospital-based physicians and how technology can help patient care.

"However you choose to participate in 2017, we will have resources available to assist you and walk you through whatever needs to be done," Mr. Slavitt wrote. "And however you choose to participate, your feedback will be invaluable to building this program for the long term to achieve the outcomes that matter to your patients."

More articles on MACRA:

Taking a MACRA view of physician independence
Preparing for MACRA: Top 3 priorities for 2016
Physicians predict Brexit from Medicare under MACRA

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