CMS has heard the concerns of many medical community members over the agency's Medicare Access and CHIP Reauthorization Act and is giving providers more flexibility to avoid hefty penalties, according to Medscape.
In a blog post, CMS Acting Administrator Andy Slavitt said the agency is giving physicians four MACRA options. CMS is also allowing physicians to adopt MACRA options slowly, without fear of penalty in 2019.
Originally, CMS had two options under MACRA — Merit-Based Incentive Payment System and Advanced Alternative Payment Models. Under MIPS, CMS will either award a bonus or a penalty to physicians based on their total scores across categories including care's cost, quality of care as well as meaningful use of EHRs. Physicians can receive penalties or bonuses reaching 4 percent of Medicare fee-for-service revenue, with this penalty or bonus increasing to 9 percent in 2022.
On the flip side, the second option under MACRA was APMs, where physicians can receive a 5 percent bonus each year if they take on a certain amount of risk. Various types of APMs include accountable care organizations, Comprehensive Primary Care Plus and track 3 of the Medicare Shared Savings Program.
Following concern over the penalties practices may accrue, Mr. Slavitt announced four MACRA options. The first option entails physicians participating in MIPS while avoiding the 2019 penalty as they can report "some" quality and cost data. The model allows physicians to test MIPS and "ensure that your system is working and that you are prepared for broader participation in 2018 and 2019 as you learn more."
The second option allows physicians in MIPS to submit quality and cost data for a portion of 2017, with the performance period under MIPS beginning no later than Jan. 1, 2017. Under this option, physicians avoid a penalty as well as quality for a 'small' bonus in 2019.
Physicians partaking in the third option can submit performance data for the full 2017 calendar year. Mr. Slavitt said he expects providers participating in this option to succeed. With the fourth option, physicians can join an Advanced APM. Both the third and fourth options have been options for physicians since CMS launched MACRA, according to Medscape.
The AMA commended CMS for addressing physician concerns and giving more opportunities for success. AMA President Andrew Gurman, MD, said, "The AMA believes the actions that the administration announced today will help give physicians a fair shot in the first year of MACRA implementation. This is the flexibility that physicians were seeking all along."
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