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MACRA Will Offer Reporting Flexibility for Physicians and Practices in 2017, CMS Says

Physicians and other clinicians will have multiple options for participation in MACRA's Quality Payment Program in 2017, announced Centers for Medicare and Medicaid Services (CMS) Acting Administrator Andy Slavitt in a Sept. 8, 2016, blog post.

Slavitt said CMS developed the new options based on feedback it received from individual physicians as well as state and national physician organizations. In June 2016, the Pennsylvania Medical Society (PAMED) sent a comment letter to CMS about the MACRA proposed rule. Read PAMED's letter here.

Options Will Enable Physicians to Avoid Negative Payment Adjustments in 2019

The Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) calls a shift toward payment for physicians based on quality of care over volume of services provided. CMS has proposed a Quality Payment Program with two tracks: the Merit-based Incentive Payment System (MIPS) and Advanced Alternative Payment Models (Advanced APMs).

CMS' recent announcement provides clarity on the timing of reporting for the first year of the Quality Payment Program which begins on Jan. 1, 2017. Slavitt outlines the choices physicians and practices have to pick their pace for participating in either MIPS or an Advanced APM.

The selection of one of the following four options will ensure that you do not receive a negative payment adjustment in 2019:

  1. Test the Quality Payment Program—Submit some data to the Quality Payment Program, including data from after Jan. 1, 2017. This option will allow physicians and practices to test their systems, so they are better prepared for a broader level of participation in subsequent years.
  2. Participate for Part of the 2017 Calendar Year—Submit information for a reduced number of days. Physicians and practices could still be eligible for a small positive payment adjustment if they begin their performance period later than Jan. 1, 2017.
  3. Participate for the Full 2017 Calendar Year—Submit performance data for the full 2017 calendar year. CMS says it has seen practices of varying sizes successfully submit quality data for a full year, and it is providing this option that offers the possibility of a modest positive payment adjustment for practices who are ready to begin now.
  4. Participate in an Advanced APM in 2017—Physicians can opt to join an eligible Advanced APM instead of reporting quality data and other information. CMS says that If you receive enough of your Medicare payments or see enough of your Medicare patients through the Advanced APM in 2017, then you would qualify for a five percent incentive payment in 2019.

PAMED members with questions can contact our Knowledge Center at 855-PAMED4U (855-726-3348).

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