In September, the Centers for Medicare and Medicaid Services Acting Administrator, Andy Slavitt, revealed that CMS is offering clinicians four options to comply with and avoid a negative payment adjustment in the Quality Payment Program (QPP) outlined in the Medicare Access and CHIP Reauthorization Act (MACRA) for 2019.
This announcement from CMS comes after intense pressure from policymakers, specialty societies (including AANEM), and other industry stakeholders.
The first three options relate to participation in the Merit-based Incentive Payment System (MIPS) track:
The first option is the most lenient and allows clinicians to submit any amount of data to the QPP after January 1, 2017, to avoid a negative payment adjustment (4% for the first year). Clinicians who choose this option will not be eligible for any bonuses. This option is designed to ensure that physicians are prepared for broader participation in 2018 and 2019.
The second option allows clinicians to submit all required data under Quality Payment Program but for less than a full calendar year. Under this option, the practice could still qualify for a small positive payment adjustment.
With the third option, physician groups can submit data that fulfills all requirements of MIPS for the entire year in 2017. These practices would be eligible for the full positive payment adjustments under MIPS. This option is for practices that are ready to fully participate in 2017.
The final option is to participate in an Advanced Alternative Payment Model (APM) (as opposed to MIPS) in 2017. However, very few clinicians will be eligible to participate in this track.
For more information on MACRA, MIPS and APM’s, please visit AANEM’s website here