Last week The Centers for Medicare and Medicaid (CMS) Acting Administrator Andy Slavitt issued an official blog post announcing proposed reporting options for the Quality Payment Program (QPP), the program stemming from the Medicare Access and CHIP Reauthorization Act (MACRA), for program year 2017. The intent of these options is to give participants more flexibility during the initial year of this significant program. For 2017, the blog post identifies four options: 1) Submit “test” data to CMS for any period of time within 2017. Choosing this option will eliminate any penalties from the MIPS program. 2) Submit complete data for a portion of program year 2017. Choosing this option will provide the opportunity for a partial incentive payment, if any is earned. 3) Submit complete data for all of program year 2017. Choosing this option provides the opportunity for a […]

2 comments

A beginner’s guide to MACRA

MACRA is perhaps the most significant piece of proposed healthcare regulation I’ve ever seen. We’ve had a series of webinars to help clients understand the key points, and distilled them here in a Q&A format. What is MACRA? MACRA stands for the Medicare Access and CHIP Reauthorization Act of 2015. It is Medicare payment reform designed to help lower the cost of health care, while delivering better quality and improving health outcomes. It creates a more comprehensive value-based framework for payment and combines different quality-based measures into one system. Is MACRA final? No. MACRA was enacted in April 2015, but a public comment period has been open from April through June 27, 2016. The government is estimating the final rule will be available in October 2016. If it’s not final, why should I worry about this now? MACRA includes many changes, […]

The Medicare Access and CHiP Reauthorization Act (MACRA) was signed into law by President Obama in April 2015 with overwhelming bi-partisan support. The bill includes many changes, and arguably the most critical impact is the introduction of a new payment model that will affect all providers starting with the 2019 payment year. Unfortunately, many in the healthcare industry have a false sense of security: while 2019 is the official start date for the new payment models, 2017 will be the performance year that determines 2019 payment adjustments. Be ready for MACRA by Jan. 1, 2017 By the end of 2016, organizations and providers must understand the impact of the MACRA changes, develop their strategies for success in the new model, and implement changes necessary to support their strategies. Organizations must start taking action now. CMS will publish the proposed rule […]

The Health Care Payment and Learning Action Network (HCPLAN) recently held its first summit in Washington, D.C.  I joined about 250 healthcare industry leaders at this event, which demonstrated that this group will play a significant role in shaping health care’s transition from fee-for-service to value-based-care models. The U.S. Department of Health and Human Services (HHS) created the HCPLAN earlier this year towards the goal of moving 30% of Medicare reimbursements to alternative payment models in 2016 and 50% by 2018. Through the HCPLAN, HHS will work with private payers, employers, consumers, providers, states and state Medicaid programs, and other partners to expand alternative payment models into their programs. Two of the main topics at the summit were the Alternative Payment Model (APM) Framework and Medicare Access and Chip Re-authorization Act (MACRA). Here’s a summary of key points in each […]