MACRA Ruling Finalized: Reporting Period Begins Jan. 2017

Late last week, CMS released the final MACRA ruling. Detailed information from a variety of sources is posted on the KHP MACRA Resource Center, and highlights from the ruling are noted below. Of note, revisions made in the final rule include flexibility in reporting options during the transition period, adjustment of low-volume thresholds for smaller practices, simplification of electronic medical record requirements, and establishment of the Advanced Alternative Payment Model (APM).

Given improvements in quality outcomes over the last two years and recent shared savings results, KHP believes eligible participants are well positioned for this transition. KHP has been selected and is currently pursuing status as a Next Generation ACO and Advanced APM to offer better outcomes to participants through this transition.

“We are ready,” said Don Lovasz, president of KHP. “Our care management team has been preparing for the shift from volume to value for some time. That’s why they are working with providers to help close the gaps with documentation and roll out the provider portal in our offices. Provider documentation of patient quality care has never been as important.”

Lovasz continued, “MACRA will be most challenging for small, independent practices. A number of independents providers have joined KHP for this reason and we anticipate others coming on-board for this reason in the future.”

If you have questions about your practice’s eligibility or know providers who are interesting in joining KHP, give us a call at 1-844-804-8725.

Highlights from MACRA final rule:

Flexibility in “transition” period:
Providers collecting performance data can begin as early as Jan. 1, 2017;
However, CMS is offering an option to start anytime between Jan. 1 and Oct. 2;
All data is due to CMS by March 31, 2018. Data collected in the 2017 performance year will determine payment adjustments beginning Jan. 1, 2019.

Four options in 2017:
No participation = automatic 4 percent negative payment adjustment;
Submission of a minimum amount of data (one quality measure) = neutral payment adjustment;
Submission of 90 days of data = potential small positive payment adjustment or neutral adjustment;
Submission of a full year of data = potential to earn a moderate positive payment adjustment.

“Exceptional performers” in MIPS, which includes the new meaningful use program, will be eligible to receive an additional bonus for each of the first six years of the program.

New meaningful use measures within the new payment program will be introduced gradually, will be simpler and more aligned with other quality reporting schemes.

Advanced APM options for 2017: Comprehensive ESRD Care Model, Comprehensive Primary Care Plus Model, Medicare Shared Savings Program Tracks 2 and 3, Next Generation ACO Model. Additional pathways for participating in the advanced APM track are in creation for 2017 or 2018.