In a Sept. 8 blog post,(blog.cms.gov) CMS Acting Administrator Andy Slavitt gave physicians a glimpse of positive improvements the agency has made to its plan for implementing the Medicare Access and CHIP Reauthorization Act (MACRA).
Details of all of the provisions -- referred to collectively as the Quality Payment Program -- will come later this fall with the release of the final rule.
But for now, the AAFP is extremely pleased to see that CMS will implement a "pick your pace" system that gives physicians some leeway and options as to when and how they jump into the program.
It's the very kind of flexibility the AAFP called for in its lengthy comment letter(1014 KB PDF) to CMS in June that lambasted federal officials for an "overly complex and burdensome" proposal that threatened to stall progress on health care payment and delivery reform.
In statement released Sept. 9, AAFP Board Chair Robert Wergin, M.D., of Milford, Neb., applauded the options Slavitt discussed in his blog, which outline how physicians can choose -- depending on their individual circumstances -- the speed at which they "move toward fully participating in the MACRA Quality Payment Program."
- CMS Acting Administrator Andy Slavitt recently published a blog outlining improvements the agency has made to its proposal to implement the Medicare Access and CHIP Reauthorization Act -- referred to as the Quality Payment Plan.
- Slavitt laid out a "pick your pace" system that gives physicians some leeway and options as to when and how they jump into the program.
- The flexibility described in the blog is the kind of action plan the AAFP called for in a June comment letter to Slavitt.
The carefully constructed recommendations the AAFP delivered to CMS in June "were particularly important for physicians in solo and small practices," said Wergin.
The participation options described in Slavitt's blog will "ensure that all physicians who participate in the program are not penalized in the first year," he added.
Family physicians can count on four options thus far for participating in the first Quality Payment Program performance period, which begins Jan. 1, 2017.
- Test the Quality Payment Program. Physicians who choose this option need only submit some data to the Quality Payment Program -- including data from after Jan. 1, 2017 -- to avoid a penalty. "This first option is designed to ensure that your system is working and that you are prepared for broader participation in 2018 and 2019 as you learn more," Slavitt explained.
- Participate for part of the calendar year. This option allows physicians to submit Quality Payment Program information for a reduced number of days. Physicians select options from a list of quality measures and improvement activities. "This means your first performance period could begin later than Jan. 1, 2017, and your practice could still qualify for a small positive payment adjustment," he noted.
- Participate for a full calendar year. Ready to jump in on Jan. 1, 2017? Go ahead and submit Quality Payment Program information for a full calendar year beginning on that date. Physicians who detail their work on quality measures, practice technology use and practice improvement activities could qualify for a modest payment bonus. "We've seen physician practices of all sizes successfully submit a full year's quality data and expect many will be ready to do so," said Slavitt.
- Participate in an advanced alternative payment model (AAPM) in 2017. Not ready or willing to report quality data and other information? This final option allows physicians to participate in the Quality Payment Program by joining an advanced alternative payment model in 2017. Participating in track two or three of the Medicare Shared Savings Program would fulfill this obligation. "If you receive enough of your Medicare payments or see enough of your Medicare patients through the AAPM in 2017, then you would qualify for a 5 percent incentive payment in 2019," Slavitt stated.
Slavitt pledged to make ample resources available to assist physicians regardless of how they choose to participate in 2017.
And he promised that physician feedback would be a valuable resource to CMS as it builds a solid program "for the long term to achieve outcomes that matter to your patients."
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