Responding to concerns from the healthcare industry, CMS announced it will provide several “pick your pace” options for providers to comply with the payment reforms in the Medicare Access and CHIP Reauthorization Act (MACRA).
In a blog post, CMS Acting Administrator Andy Slavitt said “in recognition of the wide diversity of physician practices,” full participation the first performance period of MACRA’s Quality Payment Program beginning Jan. 1, 2017, won’t be mandatory.
“During 2017, eligible physicians and other clinicians will have multiple options for participation,” Slavitt wrote. “Choosing one of these options would ensure you do not receive a negative payment adjustment in 2019.”
The four options are:
- Testing the Quality Payment Program. Providers can avoid a negative payment adjustment “as long as you submit some data,” including data from later in 2017.
- Partial-year participation. Providers would be allowed to submit information for a reduced number of days without sacrificing a chance at a positive payment adjustment. “For example, if you submit information for part of the calendar year for quality measures, how your practice uses technology, and what improvement activities your practice is undertaking, you could qualify for a small positive payment adjustment.”
- Full-year participation. If providers are prepared to submit data starting Jan. 1, Slavitt wrote they “qualify for a modest positive payment adjustment.”
- Participate in the Advanced Alternative Payment Model track for 2017. Slavitt said providers could join models like Medicare Shared Savings Programs Track 2 or 3, and if enough Medicare patients or payments go through an APM in 2017, they’ll be eligible for the track’s 5 percent incentive in 2019.
In comments on the rule, several industry groups called on CMS to push back the start of the first performance period. The American Medical Association (AMA) asked for a July 2017 start date, while the Medical Group Management Association suggested it be delayed to 2018.
More details about the different options, as well as potential changes to other parts of the rule, will be addressed in the finalized rule, which Slavitt said would be released on Nov. 1, making no mention of the “interim” final rule suggested by the AMA and other groups.