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February 21, 2017

CMS announces $100M in funding to help providers comply with MACRA

Daily Briefing

    CMS on Friday announced that it will allocate up to $100 million in grants over five years to help small health care provider practices prepare for the Quality Payment Program (QPP) created under the Medicare and CHIP Reauthorization Act (MACRA).

    Background on MACRA, QPP

    MACRA includes various payment reforms and permanently replaces Medicare's sustainable growth rate formula. Last year, CMS issued a final rule for implementing value-based payment reforms under the law. The final rule created the QPP, under which eligible providers will choose from two reporting paths: 

    • Advanced Alternative Payment Model; or
    • Merit-based Incentive Payment System. 

    CMS said 2017 is a transition year for QPP. Providers who are ready to begin participating in the programs can start collecting performance data on Jan. 1, 2017. Providers who are not yet prepared to participate have until Oct. 2, 2017, to begin collecting performance data. Participating providers must submit all data, regardless of when collection began, to CMS by March 31, 2018.

    The first payment adjustments under the programs will take effect Jan. 1, 2019, and will incorporate 2017 data.

    CMS awards funding for QPP training

    CMS said the first round of funding, about $20 million, was awarded to 11 community-based organizations to help small practices comply with QPP. Those organizations are:

    • Altarum;
    • Georgia Medical Care Foundation;
    • HealthCentric;
    • Health Services Advisory Group;
    • IPRO;
    • Network for Regional Healthcare Improvement;
    • QSource;
    • Qualis;
    • Quality Insights (West Virginia Medical Institute);
    • Telligen; and
    • TMF Health Quality Institute.

    The organizations will provide training and education about QPP to providers in individual or small group practices with 15 or fewer clinicians. Among other services, the organizations will deliver no-cost technical assistance, such as helping providers with:

    • Choosing and reporting quality measures;
    • Optimizing health IT; and
    • Strategic planning.

    CMS said it plans to disperse the additional $80 million over the next four years.

    In addition, CMS said it has launched a new telephone and email helpline for providers seeking assistance with QPP (Whitman, Modern Healthcare, 2/17; Morse, Healthcare Finance, 2/17; Leventhal, Healthcare Informatics, 2/17; Joszt, AJMC, 2/19; CMS release, 2/17).

    The field guide to Medicare payment innovation

    CMS's voluntary and mandatory payment innovation programs are accelerating the transition to accountable payment models.

    Our infographic breaks down the 12 highest profile programs as of September 2015—learn how these programs disrupt the traditional fee-for-service business model.


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