This is not a time for procrastinators as Medicare physician reimbursement undergoes its biggest change since its launch in 1965.
Final game-changing rules for the value-based reimbursement schemes contained in MACRA (short for Medicare Access and CHIP Reauthorization Act of 2015) won't be issued until as late as November. Acting CMS Administrator Andy Slavitt has hinted there could be delays in final implementation, at least for some physicians in small and rural practices.
But experts who have pored over the complex proposal issued in April said physicians and physician groups need to plow ahead.
The clock is ticking because MACRA goes into effect Jan. 1. The data collected starting next year will affect pay in 2019.
Dan Golder, a principal at Impact Advisors, a healthcare IT consultancy in Naperville, Ill., said the new regulations are daunting. “Meaningful use is first-grade arithmetic and MIPS and MACRA are college-level calculus. It's very, very complex,” he said, referring to the Merit-based Incentive Payment System.
“There's over 200 quality measures folks have to review and pick from. There's over 90 'clinical practice improvement activities,' which is another part of the MIPS. The complexity of MIPS is going to be very difficult for physicians to stomach. They're going to be really challenged to read and understand the rules and to perform at a high enough level,” he said.
But enough is known about the broad strokes to enable physicians and groups to proceed. They can adjust to any curveballs that may come their way.