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Industry Groups React to MACRA Participation Flexibilities

According to the AMA, AAFP, and ACP, the MACRA reporting flexibilities will enable more providers to successfully participate in the program.

By Sara Heath

- Several industry groups have expressed praise for the new MACRA Quality Payment Program reporting guidelines and flexibilities that CMS released late last week.


The guidelines ease the program’s reporting requirements by allowing providers to “pick their pace.”

Providers will be able to pick from four different options to avoid negative payment penalties.

The first option allows providers to submit any kind of data they have pertaining to the Quality Payment Program. While providers will not be able to receive any positive payment adjustments, they will avoid a negative penalty.

The second option allows for a reduced reporting period. Practices could begin submitting data later than the January 1, 2017 MACRA reporting start date and still potentially receive a minimal positive payment.

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The third option caters to providers ready to begin reporting on January 1. This advanced option requires providers to begin reporting on the selected date and could result in a modest positive payment adjustment.

The final option allows for providers to engage in an Advanced Alternative Payment Model (APM). Should a provider receive enough of his or her payments from Medicare or treat enough Medicare beneficiaries, she may be eligible for a five percent positive payment adjustment.

According to the American Medical Association, these flexibilities recognize that different providers are at different stages when it comes to implementing the new law.

"The American Medical Association (AMA) strongly applauds Secretary Burwell and Acting Administrator Slavitt – and their teams – for listening to physicians' concerns about the timeline that was originally proposed for MACRA,” said AMA President Andrew W. Gurman, MD, in a public statement.

"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.”

Since CMS proposed its MACRA provisions, healthcare professionals have argued that the reporting timeline was too arduous to be feasible for many practices. These new changes will make the program fairer and will help cater to the requests providers have made for many months, Gurman said.

"The AMA believes the actions that the Administration announced today will help give physicians a fair shot in the first year of MACRA implementation. This is the flexibility that physicians were seeking all along, and we are looking forward to working with Acting Administrator Slavitt and the administration on other efforts to get MACRA off to a successful start."

Other industry groups agree with the AMA. Chair of the American Academy of Family Physicians (AAFP) Robert Wergin, MD, likewise said that this new approach will make the law fairer for smaller practices.

“Family physicians welcome the news that CMS will allow physicians to choose the pace at which they will move toward fully participating in the MACRA Quality Payment Program,” Wergin said.

Following MACRA’s proposed rule, AAFP outlined a series of steps CMS could make in order to foster a more feasible and well-rounded program. In this latest announcement, AAFP has seen that CMS has heeded some of those suggestions, Wergin explained.

“Our recommendations were particularly important for physicians in solo and small practices,” he said. “The options outlined by CMS Acting Administrator Andy Slavitt ensure that all physicians who participate in the program are not penalized in the first year.”

The American College of Physicians sang a similar tune, explaining how the different reporting flexibilities will serve practices of varying sizes and preparedness.

“Choosing one of these reporting options would ensure practices do not receive a negative payment adjustment in 2019,” said ACP President Nitin S. Damle, MD, MS, FACP.

“Thus, the minimal reporting option will also allow for a longer transition period for those practices that still need time to adjust for the new MACRA performance requirements without being at risk of negative adjustments, while other practices that are able to more fully participate in 2017, for some or all of the year, could qualify for ‘small’ to ‘modest’ positive adjustments.”

Damle underscores that this new rule does not change the reporting start date for MACRA. While providers may be seeing increased flexibility with their reporting options, they still need to begin submitting data in 2017.

“It is important to note that this announcement does not delay the initial performance period of MACRA; some level of participation would be required for each of the options in order for a practice to not be subjected to negative adjustments,” he explained.

“However, it provides the time and flexibility needed for those practices to choose the pace of their participation, while allowing those who are ready to report beginning January 1, 2017 to be eligible for a positive payment adjustment.”

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