NOTE: If you are interested in the proposed changes to Medicare Access and CHIP Reauthorization Act, the West Virginia Rural Health Conference in October features a presentation on MACRA 2018 and other recent legislative changes. For session information, and to register, visit: wvrha.org/2017-west-virginia-rural-health-conference/
It certainly was a busy few days in Washington for the healthcare sector last week. The Senate revealed the discussion draft of their healthcare reform plan, hoping to come to a vote sometime this week. But in case you missed it, the CMS unveiled another highly-anticipated federal document last week: the 2018 Quality Payment Program (QPP) proposed rule.
After having some time to digest the final rule and reactions, here are the most important takeaways from the proposed rule.
In 1,058 pages full of dense legislative language, the agency laid out the ground rules for the second year of MACRA, the rule QPP implements. At the rule’s announcement, the CMS messaged it was allowing flexibility for the rule by proposing the exemption of small providers participating in the program. The agency believes the move will exclude about 134,000 clinicians from the program, adding to the already 800,000 clinicians exempted from MACRA’s Merit-based Incentive Payment System (MIPS).
After having some time to digest the final rule and reactions, here are the most important takeaways from the proposed rule:
#1 – Only 36% of clinicians will be eligible for MIPS after all exclusions, but they make up 58% of Medicare Part B charges
MACRA/QPP is a massive piece of legislation.
At it’s core, MACRA will eliminate the sustainable growth rate formula and replace it with a 0.5% annual rate increase through 2019, after which physicians are encouraged to shift to one of two Quality Payment Programs: 1) Merit-Based Incentive Payment System (MIPS) or 2): Alternative Payment Model (APM)…