MACRA will begin on Jan. 1, 2017, and according to CMS Acting Administrator Andy Slavitt physicians will have more options to comply and avoid a negative payment adjustment in 2019.
The announcement comes after intense pressure from industry stakeholders and policymakers to ease implementation of the Medicare Access and CHIP Reauthorization Act, which is set to start Jan. 1, 2017. Just two months ago, CMS announced the agency was considering delaying the start date.
Now, CMS seems to be conceding a bit of ground by adding more flexibility to the MACRA program with four options for participation:
Option One: The first option is designed to ensure more physicians are prepared to participate in 2018 and 2019 and will enable clinicians to submit data to the Quality Payment Program, including data after Jan. 1, 2017, and still avoid a negative payment adjustment.
Option Two: The second option will allow participation for part of the calendar year. Physicians may choose to submit Quality Payment Program information for a reduced number of days. The first performance period could begin later than Jan. 1, 2017, and the practice could still qualify for a small positive payment adjustment. This option can include the submission of information on how the practice uses technology and what improvement activities are being used. Physicians will choose from a list of quality measures and improvement activities under the Quality Payment Program in this category.
Option Three: The third option will allow physician groups to submit information for the entire 2017 year on quality measures and could qualify for a modest positive adjustment.
Option Four: The fourth option is for physicians participating in an Advanced Alternative Payment Model in 2017. Instead of reporting quality data and other information, the law allows participation in an Advanced APM, such as Medicare Shared Savings Track 2 or 3 in 2017. Physicians that receive enough of their Medicare payments or see enough of their Medicare patients through an Advanced APM in 2017 would qualify for a 5 percent incentive payment in 2019.
These changes come in response to feedback on CMS’s April proposal for implementing the Quality Payment Program on how excessive reporting can distract from patient care; how to encourage new programs, such as medical homes; and the unique issues facing small and rural non-hospital-based physicians, Slavitt wrote in a blog post.
More details on these options will become available when CMS releases its final rule for implementing the Quality Payment Program, sometime before Nov. 1.