The Centers for Medicare and Medicaid Services on Thursday announced that it will give providers several options to comply with the new quality payment program being implemented under the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA).
In a September 8 blog, CMS Acting Administrator Andy Slavitt said physicians could “pick their pace of participation” for the first performance period of the quality payment program that begins January 1.
“During 2017, eligible physicians and other clinicians will have multiple options for participation,” wrote Slavitt. “Choosing one of these options would ensure you do not receive a negative payment adjustment in 2019. These options and other supporting details will be described fully in the final rule,” which he said is expected by November 1.
According to Slavitt, these are the four options available to providers:
Option 1: Test the quality payment program. With this option, as long as providers submit some data to the quality payment program, including data from after January 1, 2017, they will avoid a negative payment adjustment. This first option is designed to ensure that provider systems are working and that they are prepared for broader participation in 2018 and 2019.
Option 2: Participate for part of the calendar year. Providers may choose to submit quality payment program information for a reduced number of days. This means their first performance period could begin later than Jan. 1, 2017, and their practice could still qualify for a small positive payment adjustment. For example, if they submit information for part of the calendar year for quality measures, how their practice uses technology and what improvement activities their practice is undertaking, they could qualify for a small positive payment adjustment. Providers could select from the list of quality measures and improvement activities available under the quality payment program.
Option 3: Participate for the full calendar year. Practices that are ready to go on Jan. 1, 2017, may choose to submit quality payment program information for a full calendar year. This means their first performance period would begin on Jan. 1, 2017. For example, if they submit information for the entire year on quality measures, how their practice uses technology and what improvement activities their practice is undertaking, they could qualify for a modest positive payment adjustment.
Option 4: Participate in an advanced alternative payment model in 2017. Instead of reporting quality data and other information, the law allows providers to participate in the quality payment program by joining an advanced alternative payment model, such as Medicare Shared Savings Track 2 or 3 in 2017. If providers receive enough of their Medicare payments or see enough of their Medicare patients through the advanced alternative payment model in 2017, then they would qualify for a 5 percent incentive payment in 2019.
“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 wrote. “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.”
Also See: How to prepare for the shift to MACRA
Responses to the CMS announcement from industry groups and lawmakers were very positive. The American Medical Association applauded the agency’s flexibility.
“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 AMA President Andrew Gurman, MD, in a written statement. “This approach better reflects the diversity of medical practices throughout the country.”
Gurman added that the flexibility “will help give physicians a fair shot in the first year of MACRA implementation.”
Likewise, the American Hospital Association said it approved of the CMS actions.
“We are pleased that CMS has responded to feedback asking for greater flexibility in meeting MACRA’s aggressive timeline and reporting requirements,” said Ashley Thompson, AHA senior vice president for public policy analysis and development. “We look forward to reviewing the details of these options when CMS releases a final rule.”
Rep. Michael Burgess, MD (R-Texas), chairman of the House Energy and Commerce Subcommittee on Commerce, Manufacturing and Trade, said he was pleased to hear that CMS was going to be flexible in transitioning to the new payment reporting requirements.
Burgess said the “announcement from CMS regarding the agency’s dedication to flexibility in the implementation of MACRA is proof of the benefits of keeping Congress involved in policy implementation,” adding that “just as this policy was carefully crafted with the input of everyone affected by the payment policies, the implementation process should be conducted in the same way.”
He said he is “committed to leading the charge for continued congressional oversight of MACRA implementation to ensure simplified, streamlined requirements that allow for all doctors to succeed.”
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