Previous estimates not 'realistic;' small practices can succeed under MACRA, CMS claims — 9 key points

Practice Management

In a hearing last week, Acting CMS Administrator Andy Slavitt said small practices can succeed just as much as larger practices in regard to CMS' Medicare Access and CHIP Reauthorization Act, according to Medscape.

Here are nine essentials:

 

1. CMS initially estimated most clinicians in groups of 24 or less will endure a penalty in 2019. Initial estimates anticipated CMS' Merit-Based Incentive Payment System would provide bonuses or penalties to nearly 102,788 solo practitioners. Of that figure, nearly 87 percent would face MIPS penalties in 2019.

 

2. For practices comprised of two members to nine members, initial estimates found nearly 69.9 percent would face penalties. On the other hand, for practices with 100 members or more, initial estimates anticipated CMS would only issue penalties to 18.3 percent of large practices.

 

3. Mr. Slavitt is claiming that figure is not indicative of the reality and CMS will help small practices so they can succeed in obtaining bonuses.

 

4. At the hearing, Mr. Slavitt said the 2019 estimates speak to the importance of making reporting less of a burden for physicians in small practices whose primary focus should be treating patients.

 

5. On its website, CMS posted a document titled "Flexibilities and Support for Small Practices." The document said CMS understands the concerns small practices may have regarding their Quality Payment Program and will be flexible to ensure they are not disproportionably penalized.

 

6. CMS's document states the agency will only subject practices of nine or less clinicians to two population health measures in the quality category compared with three measures for larger groups.

 

7. Practices of nine clinicians or fewer can choose the measurements and reporting systems best suited for their practices, and they may earn bonus points through additional reporting.

 

8. MACRA allots $100 million over five years for technical assistance to practices with 15 or fewer clinicians, particularly in rural and underserved areas.

 

9. CMS is accepting comments from the public on the proposed MACRA regulations until June 27.

 

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