5 experts weigh in on what the new MACRA proposal means for you
by Krista Teske, Consultant, Physician Practice Roundtable
In last year's QPP rulemaking cycle, it became abundantly clear that smaller groups were not likely to fair well under MIPS. Recall that CMS estimated that 42% of groups with one to nine eligible clinicians would receive a negative payment adjustment under the program.
This time around is a different story: The 2018 proposal shows CMS is dedicated to leveling the playing field for smaller groups. They propose doing so in two key ways:
- By making it easier for smaller groups to meet the MIPS requirements by giving them preferential treatment in certain MIPS categories and adding virtual groups as a participation option; and
- By increasing the threshold of Part B patients or charges necessary for an eligible clinician or group to be subject to MIPS from ⋜$30,000 in Part B allowed charges or ⋜100 Part B beneficiaries to ⋜$90,000 in Part B allowed charges or ⋜200 Part B beneficiaries.
But if providers think they could get away scathe-free and avoid MIPS altogether because of these elevated thresholds, they should think again.
Read more from Krista and four other experts:
10 takeaways on the MACRA proposed rule
by Dennis Weaver
Takeaway No. 1: Two overall trends are clear: Payment and delivery system reforms are moving ahead, and the administration wants to reduce the regulatory burden of MACRA on providers. This was the new administration's first time to put their stamp on MACRA's QPP and they largely left the structure the same—and in fact gave clinicians more ways to succeed in the program, while also offering significant flexibility to providers.
Takeaway No. 2: About 134,000 more clinicians—mostly those who work in small practices and those that practice in rural regions and Health Professional Shortage Areas—would be exempt from participating in the QPP altogether. CMS in 2017 allowed providers to be exempt if they had less than $30,000 in Medicare Part B revenue or saw fewer than 100 Medicare Part B patients per year. The agency is now proposing that physician practices making less than $90,000 or caring for less than 200 Medicare patients would not have to participate in the program.
Read more from Dennis Weaver:
Get the infographic: 5 things everyone should know about MACRA
Payment adjustments under MACRA don’t begin until 2019, but they are based on performance measurement commencing in 2017.
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