MACRA: CMS will give docs 4 options for 2017

Bowing under industry pressure, the Centers for Medicare & Medicaid Services announced Thursday it would ease the implementation of the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA), set to take effect on Jan. 1, 2017.

MACRA changes how CMS pays practices that provide care to Medicare beneficiaries, placing emphasis on quality care and improved patient outcomes. Physicians can take part via the Merit-based Incentive Payment System (MIPS), or an alternative payment model.

Physician practices will now have four options in order to “pick their pace” to comply with the new Medicare payment reform system, according to Andy Slavitt, acting administrator of CMS.

Option 1: As long as physician practices submit some data to the quality payment plan (including data from after Jan. 1, 2017), they will avoid a negative payment adjustment. This option will allow practices to “test” their systems and show CMS that it works and the practice is prepared for broader participation in 2018 and 2019.

Option 2: Submit data for part of the calendar year. Practices can still qualify for a small positive payment adjustment, even if the data for their first performance period begins after Jan. 1. This data would include quality measures, how your practice uses technology and quality improvement efforts.

Option 3: For practices that are already prepared for MACRA on Jan. 1, they can submit data for a full calendar year and could quality 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,” Slavitt said.

Option 4: Participate in an advanced alternative payment model, such as Medicare Shared Savings Track 2 or 3 in 2017. Practices that receive enough Medicare payments or see enough Medicare patients through the model could qualify for a 5 percent incentive payment in 2019.

Slavitt said more details on all the options will be provided in the final rule, which will be released by Nov. 1.

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

The decision to give physicians more flexibility came as welcome news to Congressman Rep. Michael Burgess (R-Texas). In a statement to the press, Burgess, a trained obstetrician, said he was committed to leading the charge for continued Congressional oversight of the process to ensure "simplified, streamlined requirements that allow for all doctors to succeed."

Blair Childs, senior vice president of public affairs, for Premier, Inc., said in a statement that the alliance appreciates the direction CMS has given providers prior to the release of the final rule. But he hopes CMS will also listen to providers and reduce the level of risks for advanced alternative payment models and take steps to create more ACO tracks to provide additional opportunities for eligible clinicians to obtain the percent incentive payment.