MACRA Implementation: January 1, 2017

As we move ever closer to the January 1, 2017 implementation of the Medicare Access and CHIP Reauthorization Act (MACRA) as well as the final rule (scheduled for November 1), here’s a look at some of the recent updates regarding the new reporting framework.

Reporting options

According to Andy Slavitt, the acting administrator for the Centers for Medicare and Medicaid Services, there will be at least four options for healthcare providers to meet MACRA standards and avoid a “negative payment adjustment” in 2019. 

HealthLeadersMedia reporter Christopher Cheney, who referred to them as the “pick-your-pace” options (, sums them up as follows: 

  1. Submitting enough data to the Quality Payment Program “to ensure that your system is working and that you are prepared for broader participation in 2018 and 2019.”
  2. Submitting the full set of performance data for less than the full 2017 calendar year.
  3. Submitting the full set of performance data for the full 2017 calendar year.
  4. Participating in an Advanced APM [Alternative Payment Model] in 2017. 

In other words, by being compliant under any of these four options, providers will be able to avoid being penalized while displaying efforts to move toward full MACRA compliance. It also allows for more of a transition period than was previously explained. 

The options were met with praise from professional organizations, including the American Medical Association (AMA). 

“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.,” said AMA president Andrew Gurman, MD, in a statement. “This approach better reflects the diversity of medical practices throughout the country.”

(Read more on the four options:

New tools available

More good news from the AMA, as the organization announced in early October that it has launched a series of web tools available to healthcare providers to assist in the MACRA transition. 

The two tools — the AMA Payment Model Evaluator and the AMA STEPS Forward — are available to any provider that has a login to the AMA website, according to HealthcareITNews ( They do not require AMA membership. 

The Evaluator is designed to help providers choose which MACRA payment model makes the most sense for them, while STEPS Forward is a series of 42 modules that include case studies and practical solutions as well as downloadable resources.

The tools are accessible at

MACRA is bad

And now for something completely different. While the industry is preparing for MACRA, at least one physician is speaking out against the new payment model.

Kristin Held, MD, an ophthalmologist based in San Antonio, wrote in the fall issue of the Journal of American Physicians and Surgeons, that “scoring and grading physicians through financial incentives and penalties in order to drive behavior would, in other contexts, be called bribery and extortion.”

Held also expressed her concern for potential infringement to patient privacy due to the reporting requirements in place by the CMS for MACRA compliance.

“Private physicians cannot ethically comply with MACRA,” she wrote. “If this rule goes forward as promulgated, many more physicians will opt out of Medicare and commercial insurance.” 

Read more:

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