By Jill Drachenberg, Managing Editor, AHC Media
Physician groups breathed a sigh of relief after CMS announced Thursday that participation in the Medicare Access and CHIP Reauthorization Act (MACRA) of 2015 will ease physicians into compliance and will provide participation flexibility.
Physicians will be able to choose the pace at which they come into compliance with MACRA, the legislation that repealed the much-reviled Sustainable Growth Rate. But physicians also are wary about the payment structures, data reporting, and other paperwork involved with MACRA, and fear they would not be ready for the Jan. 1, 2017, start date.
The changes allow physicians to choose one of the four following options:
- Report some amount of quality data, including from after Jan. 1, 2017, to avoid negative payment adjustment in 2019. This option allows providers to ease into the data collection/reporting requirements and increases the amount of data reported over time.
- Submit data from part of the calendar year to avoid a negative adjustment. This could mean the reporting period can start after Jan. 1. Practices can get a small, positive adjustment if they submit data on certain quality measures and use of technology.
- Practices that are ready to do so can choose to submit a full calendar year of data and qualify for a “modest” positive payment adjustment.
- Practices may participate in an Advanced Alternative Payment Model, such as an accountable care organization, instead of submitting data to MACRA. If these practices see “enough” Medicare patients or receive enough payment through such models, they will be eligible for a 5% incentive payment in 2019.
CMS faced pressure from medical associations and lawmakers in Congress over MACRA’s implications, particularly for small and rural practices that may not have the bandwidth to fulfill the reporting requirements.
"By adopting this thoughtful and flexible approach, the administration is encouraging a successful transition to the new law by offering physicians options for participating in MACRA,” said American Medical Association President Andrew W. Gurman, MD, in a statement. “This approach better reflects the diversity of medical practices throughout the country.”
More information on MACRA implementation guidelines and implications for physician practices will be available in the October issue of Hospital Peer Review.
For more information on how to make MACRA work for your practice and receive the maximum benefit, check out our on-demand webinar, Maximize Your Money Under MACRA.