A week ago, physicians and health system leaders were sweating a waning number of days to figure out and prepare for Medicare's new incentive payment framework in time to report performance data to the CMS. Now they face a lower-stakes set of decisions but the same mandate to wean themselves off of fee-for-service pay.
The CMS was flooded with nearly 4,000 comment letters after issuing its draft rule for carrying out the Medicare Access and CHIP Reauthorization Act. Many of them asked for flexibility, and last week acting CMS Administrator Andy Slavitt answered with a blog post promising two new “pick your pace” options for avoiding penalties.
“We're making the consequences of not being ready more modest as these models start up,” Slavitt told Modern Healthcare. “The bull's-eye for us isn't what will happen with this program in 2017, it's about what will lead to the best patient care in the long term.”
The physician community welcomed Slavitt's gesture, but they're also continuing to press him for a more expansive opportunity to duck that system altogether.
To avoid penalties and qualify for bonuses under MACRA, physicians must participate in the new Merit-based Incentive Payment System (MIPS, for short) unless they have a substantial amount of their revenue at risk under a qualifying alternative payment model—and the vast majority of physicians do not.
Physicians were supposed to start reporting performance data next year, and many complained that smaller practices in particular wouldn't be ready. The framework calls for them to choose from an array of measures in four categories: quality, resource use, clinical practice improvement and meaningful use of electronic health records. The final rule on those measures, however, isn't expected to arrive until November.