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What you don't know about MACRA for 2017

 For your consideration here are four options provided by CMS

Option 1: Trial the Quality Payment Program. This program allows you to avoid negative payment adjustment by submitting some data to the quality payment program. A big benefit of this program is that you can evaluate whether your system is currently working as your participation will be more demanded in 2018 and 2019

Option 2: Take part in a fraction of the Calendar Year. If you want the first performance period to be later than Jan 1, 2017 you can choose to submit Quality Payment Program information for a lower amount of days.

Option 3: Take part in the entire calendar year. For the practices that are ready to go on Jan 1, 2017 it would be advantageous for you to submit Quality Payment Program information for the entire year. This means that on Jan 1, 2017 your performance period would begin. With this option you may be able to receive a modest positive payment adjustment.

Option 4: In 2017 take part in an advanced alternative payment model. If reporting quality data is not your cup of tea you can join a advanced alternative payment model which gives you the option of participating in the quality payment program. Even though this strategy is more financially risky, you may qualify for a 5 percent incentive payment in 2019 if you see enough medicare patients.

Should you decide just to not participate?

You may be tired hearing about MACRA every day; however you should consider the consequences of not participating. First, the hit for medicare reimburesment is substantial. In 2019 there is a 4% penalty and in following years the percentage will increase even more. There still may be an overriding reason to not participate. Here are three groups that I believe physicians will fall into in regards to participation.

  1. You just started your practice so participation is mandatory. If you do not participate from the start your scores and ratings will be devastating to the long term financial help of your practice.
  2. You are in the middle of your career. If this is the case you have no other option but to participate in the program seeing that you need long term stability for your practice.
  3. You are near the end of your career. If this is the case not participating does not have much of a financial bearing over your decisions.

Overall the decision of whether to participate is a tough one and should not be taken likely. The future of your practice will indefinitely be intertwined with your participation in these programs.

 NOVEMBER 25, 2016