Medicare grants doctors flexibility in new payment system

Medicare grants doctors flexibility in new payment system

The administration is relieving some pressure on Medicare physicians subject to complex new payment requirements in 2017. 

The Centers for Medicare and Medicaid Services (CMS) on Sept. 8 released four options for Medicare doctors complying with the new requirements instituted under last year’s Medicare Access and CHIP Reauthorization Act (MACRA). Doctors previously were given two participation options slated to begin Jan. 1.


The additional options mark a softening of the administration’s stance on the issue, but stop short of a full delay from Jan. 1. Medical groups had lobbied hard to push the timeline back, and the CMS previously had indicated they would consider a delay. 

The American Medical Association applauded the move. 

“By adopting this thoughtful and flexible approach, the Administration is encouraging a successful transition to the new law by offering physicians options for participating in MACRA. This approach better reflects the diversity of medical practices throughout the country,” the AMA said.  

Republicans, who have been critical of the timeline, also applauded the CMS for adopting the changes. 

“Today’s announcement from CMS regarding the agency’s dedication to flexibility in the implementation of MACRA is proof of the benefits of keeping Congress involved in policy implementation,” Rep. Michael BurgessMichael Clifton BurgessTexas Republicans condemn state Democrats for response to official calling Scott an 'Oreo' Americans have decided to give professionals a chance Six ways to visualize a divided America MORE (R-Texas) said in a statement. “Just as this policy was carefully crafted with the input of everyone affected by the payment policies, the implementation process should be conducted in the same way.” 

The first of the new options allows doctors to submit any information to the CMS to avoid a negative payment adjustment. CMS Acting Administrator Andy Slavitt said in a blog post that the option is meant to ensure physicians’ systems are working properly and are “prepared for broader participation in 2018 and 2019.”

Option two allows physicians to participate for a partial year, meaning doctors can begin reporting data later than Jan. 1. These providers are eligible for a “small positive payment adjustment.”

The last two options are part of the original plan for physicians prepared to participate for the full calendar year in one of the proposal’s two payment tracks: the Merit-based Incentive Payment System and the Advanced Alternative Payment Model (APM), which involves taking on more risk. Option three lets providers begin participating Jan. 1, and option four gives doctors a 5 percent payment bump if a certain percentage of their services come from an APM.

Slavitt said there are many providers who are prepared for the new system’s original timeline. 

A final rule is expected no later than November, which would have left doctors two months to prepare for the system’s implementation on Jan. 1.