CMS releases 2018 MACRA proposed rule to ease burdens for independent practices

The Centers for Medicare & Medicaid Services (CMS) recently released a proposed rule for 2018 that marks the first major changes to the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA). This proposed rule, which totals 1,058 pages, “would make changes in the second year of MACRA’s Quality Payment Program (QPP), with the aim to simplify the program, especially for small, independent and rural practices.”

Some of the changes for 2018 include:

  • “Pick your pace” will no longer be an option. CMS has included “flexibilities” in the 2018 rule, including virtual group participation, but 2017 will be the end of the “pick your pace” option.
  • More clinicians will be exempt from MIPS. The thresholds for required participation in the Merit-based Incentive Payment System (MIPS) have increased, out of fear that many very small practices would not have the resources needed to be successful. The 2018 proposed rule includes “increasing clinicians’ low-volume threshold from $30,000 or less in Medicare Part B allowed charges or less than 100 Medicare patients to $90,000 in Part B allowed charges or less than 200 Medicare patients.”

Further, the CMS Fact Sheet, Proposed Rule for Quality Payment Program Year 2, lists a number of proposals included “in an effort to continue to reduce burden and offer flexibilities to help clinicians to successfully participate”:

  • Continuing to allow the use of 2014 Edition CEHRT (Certified Electronic Health Record Technology), while encouraging the use of 2015 edition CEHRT.
  • Adding bonus points in the scoring methodology for caring for complex patients and for using 2015 Edition CEHRT exclusively.
  • Incorporating MIPS performance improvement in scoring quality performance.

As healthcare shifts away from fee-for-service reimbursement, Elation Health will continue to monitor updates to MACRA for 2018 and beyond. As a partner for independent physicians during the transition to MACRA, we’re here to arm physicians with the information they need to be focused first and foremost on providing high-quality care for patients.

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