Making sense of MACRA’s new options for providers

September 16, 2016

Leona Rajaee

Making sense of MACRA’s new options for providers September 16, 2016

The CMS recently announced that it plans to give providers the opportunity to pick one of four different options for how they comply with the Medicare Access and CHIP Reauthorization Act (MACRA) or the “Quality Payment Program”, which is set to begin on January 1. This announcement comes after intense pressure from policymakers and physicians to give providers that did not feel ready for full implementation of MACRA’s reporting requirements more flexibility.

This means that providers now have choices in how quickly they shift towards the new structure of reimbursement. For any providers accepting Medicare, this is a critical time to understand the options to make decisions that will impact the future of their practice.

What are the options?

First Option: Test the Quality Payment Program. This first option takes a bare bones approach to participating in MACRA. Providers simply have to submit some data from after January 1, 2017 to avoid the negative payment adjustment. This option exists to ease providers into greater participation in 2018 and 2019.
Second Option: Participate for part of the calendar year. The second option lets providers participate in MACRA for a reduced number of days, while still qualifying for a small payment if the participant submits data on how their practice is using technology and what it’s doing to improve.
Third Option: Participate for the full calendar year. This options allows practices that are ready to go on January 1, 2017, to fully participate in the Quality Payment Program for a full calendar year.
Fourth Option: Participate in an Advanced Alternative Payment Model in 2017. The final option for practices is to participate in an Advanced Alternative Payment Model (APM). This option would exclude providers from the MIPS reporting required in the other options and and instead gives providers the chance to qualify for a 5 percent annual bonus. An example of this is the CPC+ program.

What does this mean for independent physicians and their practices?

Independent providers that participate in the program will not be penalized during the first year.
Practices worried about MACRA can now give themselves more time to prepare for the program, while more prepared practices can still benefit from positive payment adjustments.
Overall MIPS will be significantly easier to comply with and practices of all sizes now have more flexibility, which could lead to a more successful transition come 2017.

How to get ready for MACRA:
However your practice chooses to participate, Elation is ready to provide the resources needed to help. We have health policy specialists available to help you navigate MACRA and other policy changes, and we are committed to ensuring our certified EHR is approved for future CMS programs.

Are you ready to participate in MACRA in 2017? Which option will you choose? Comment below!