CMS Outlines Plan to Add Flexibility to MACRA Implementation Timeline

September 20, 2016

A recent blog post by Andrew Slavitt, acting administrator of the Centers for Medicare & Medicaid Services (CMS), outlined four options that will allow providers to select the pace at which they implement the Medicare Access and CHIP Reauthorization Act (MACRA) in their practices in 2017.

Beginning on Jan. 1, 2017, the MACRA Quality Payment Program requires that 2017 quality data from physician services be reported to the Centers for Medicare and Medicaid Services (CMS) in 2018. CMS will evaluate these data and use them to make payment adjustments starting in 2019.

Rather than requiring physicians to fully participate in either the Merit-Based Incentive Payment System (MIPS) or an advanced alternative payment model (APM) to meet quality reporting requirements in 2017—as was initially anticipated—Medicare providers may choose any of the options below to ensure that they will not incur a financial penalty in 2019:

  • First Option: Test the Quality Payment Program Participants who choose to report only some data—but for the full calendar year, beginning Jan. 1—would receive no bonus, but would also avoid any penalties.
  • Second Option: Participate for part of the calendar year - Providers who choose this option must report on all MIPS categories—but for less than a full year and beginning later than Jan. 1—in order to receive smaller bonuses.
  • Third Option: Participate for the full calendar year - Starting Jan. 1, physicians who choose to report a full year of data under MIPS could receive the maximum bonus, depending on their performance score. 
  • Fourth Option: Participate in an APM - Practices that join an APM (such as Medicare Shared Savings Track 2 or 3) would qualify for a 5 percent bonus in 2019.

Any of these options ensure that providers will not receive a negative payment adjustment in 2019, and each will be described fully in the final MACRA rule (expected out this fall). While these options offer flexibility and a longer transition period for practices that need more time to prepare for MACRA implementation, practices that do not submit any quality data from 2017 will be penalized in 2019.

Stay tuned to ASCO in Action for the latest on MACRA implementation. As your partner in practice, ASCO will keep members informed, and will release detailed analysis of the final rule shortly after its release.