[Breaking News] Five things to know about the final MACRA law

[Breaking News] Five things to know about the final MACRA law

Last month, CMS announced several options for providers to comply with the Medicare Access and CHIP Reauthorization Act (MACRA). Many of the changes in today’s final ruling significantly reduces the burden on small and independent practices. CMS received a great deal of feedback from this group in response to the initial draft of MACRA, and the changes announced today reflect that this feedback was heard and incorporated into the final rule.

Overall, this is very good news for independent practices, and for those who operate in environments with 10 or fewer clinicians. This is because providers will have more time to transform their practice delivery models to comply with the requirements of MIPS, or to decide to participate in an APM – and thus the expected financial impact of the new law on smaller practices is expected to soften.

Here’s a quick summary of the key points released today.

More support for small and independent practices.

  • Lower requirements for Medicare patient volumes: 2017 now excludes providers who see less than $30,000 in Medicare Part B allowed charges *or* see 100 or fewer Medicare patients (approximately 1/3 of pre-exclusion Medicare clinicians)
  • Ability to join virtual groups: In the future (as early as 2018), solo and small practices of 10 or fewer clinicians will have the option to combine MIPS reporting by forming “virtual groups”
  • Availability of financial support: CMS has dedicated $100M over five years in technical assistance to “MIPS-eligible clinicians in small practices, rural areas, and practices located in geographic health professional shortage areas”

“We estimate that over 90 percent of MIPS eligible clinicians will receive a positive or neutral MIPS payment adjustment in the transition year, and that at least 80 percent of clinicians in small and solo practices with 1-9 clinicians will receive a positive or neutral MIPS payment adjustment.”

– Centers for Medicare Medicaid Services,Quality Payment Program Executive Summary, 10/14/2016

More options for Advanced Alternative Payment Models, which provide an alternative to the MIPS track.

  • New Advanced APMs will be announced, and current APMs will be modified to meet participation requirements. CMS expects as many as 250,000 providers to become Qualifying APM Participants (QPs).
  • Other Payer Advanced APMs: Advanced APMs arranged with commercial payers or Medicaid can also qualify out of MIPS.

How do I prepare my practice for the upcoming changes?

Although today’s news does introduce more flexibility for small and independent practices, MACRA marks one of the biggest healthcare changes in our country’s history. All clinicians who see Medicare patients should educate themselves about the requirements of MACRA, as there will be significant financial and operational impacts of this policy on these practices.

Elation is here to help you and your practice continue to thrive under MACRA. We are investing in both technology to assume the burden of compliance, and we are offering a resource series to help you learn more about your options.

Elation’s MACRA resource series will include the following:
Live webinars to walk you through the changes and give you a chance to receive answers to your questions

  • Video content so that you can learn more about MACRA on your own time
  • Email newsletters with policy updates as soon as they happen
  • Articles with detailed explanations on specific topics relating to MACRA
  • Access to health policy specialists to answer any of your questions over the phoneClick here to start using Elation’s MACRA resource kit.