MACRA for Busy Docs: 12 Things to Know

Leigh Page


September 07, 2016

In This Article

Editor's Note: This article has been updated to reflect the September 9, 2016, announcement from CMS changing MACRA's reporting requirements for 2017.

Breaking Down the Key Issues

The Medicare Access and CHIP Reauthorization Act (MACRA) is a complex law that will affect physicians in a wide variety of ways for many years to come. It covers such issues as data reporting, new practice models, evolving clinical standards, and physician evaluations, and it involves hundreds of millions of dollars in penalties and bonuses.

MACRA will begin in January, 2017. Until a September 9 reprieve that was recently announced, measurements that would be used for the MACRA program would start on January 1, 2017, and the first payment adjustments would have taken place in 2019. However, CMS just announced that it will give physicians four MACRA options for 2017 that would let them choose how quickly they'd implement MACRA, and each option would avoid a penalty in 2019.

CMS Acting Director Andy Slavitt described the four options, although more details are to come. The first MACRA option allows physicians in MIPS (the Merit-Based Incentive Payment System) to avoid a penalty in 2019 by reporting "some" quality and cost data in 2017, rather than all the data required under MACRA's Quality Payment Program (QPP).

Option two allows physicians in MIPS to submit the required quality and cost data for just part of 2017. The performance period would not have to begin on January 1, 2017. Physicians doing this not only will avoid a penalty, but also could potentially earn a modest bonus in 2019.

Option three involves submitting performance data for the entire calendar year in 2017, which was the original goal of MACRA. And the fourth option is to join an Advanced APM.

MACRA is clearly on its way forward, so it's wise to know some key issues about MACRA. Here are 12 things you need to know.


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