Experience. Integrity. Advocacy.
Experience. Integrity. Advocacy.

MACRA Quality Payment Program: Pick Your Pace


Comments on the new MACRA Quality Payment Program (QPP) are still being evaluated, and we don’t expect the Centers for Medicare and Medicaid Services (CMS) to publish the final rule on the program until later in the fall, but one thing seems to be certain: CMS is listening to physicians about the timing of the program.

In a blog post late last week, CMS Acting Administrator Andy Slavitt announced that providers will have four options for when and how they begin the the QPP. By choosing any of these options, providers would avoid a negative payment adjustment in 2019.

Here’s a brief overview:

First Option: Test the Quality Payment Program.

Not sure about the details of the QPP? With this first option, you can test the waters without the risk of a negative adjustment. As long as providers submit some data to the program after January 1, 2017, they will avoid a negative payment adjustment but with the benefit of ensuring their system is working and they are prepared for broader participation in 2018.

Second Option: Participate for part of the calendar year.

With this option, providers would still submit all required data of the QPP but for a reporting period less than the entire 2017 calendar year. Choosing this option would also allow providers to qualify for a small positive payment adjustment under the QPP.

Third Option: Participate for the full calendar year.

Ready to go on January 1, 2017? Then you can submit QPP data for a full calendar year and qualify for a modest positive payment adjustment. According to CMS, physician practices of all sizes have successfully submitted a full year’s worth of quality data in the past, and they expect many practices will be ready to fully participate.

Fourth Option: Participate in an Advanced Alternative Payment Model in 2017.

Instead of reporting quality data and other information, MACRA allows providers to participate in the QPP by joining an Advanced Alternative Payment Model (AAPM), such as a Medicare Shared Savings Track 2 or 3 in 2017. Providers who receive enough Medicare payments or see enough Medicare patients through the AAPM in 2017 would also qualify for a 5 percent incentive payment in 2019.

“However, you choose to participate in 2017, we will have resources available to assist you and walk you through what needs to be done,” Slavitt wrote as part of the announcement.  “And however you choose to participate, your feedback will be invaluable to building this program for the long term to achieve outcomes that matter to your patients.”

Providers have generally responded positively to the new flexibilities. “The American Medical Association (AMA) strongly applauds Secretary Burwell and Acting Administrator Slavitt – and their teams – for listening to physicians’ concerns about the timeline that was originally proposed for MACRA,” AMA President Andrew W. Gurman, M.D. said in a prepared statement. “By adopting this thoughtful and flexible approach, the Administration is encouraging a successful transition to the new law by offering physicians options for participating in MACRA.  This approach better reflects the diversity of medical practices throughout the country.”

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Charity Singleton Craig

Charity Singleton Craig is a freelance writer and editor who provides communications and marketing services for CIPROMS. She is responsible for creating, editing, and managing all content, design, and interaction on the company website and social media channels in order to promote CIPROMS as a thought leader in healthcare billing and management.

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