As part of the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA), the Quality Payment Program includes provisions which will repeal the Sustainable Growth Rate formula, streamline existing Medicare reporting systems, and provide opportunities for clinicians to earn more by focusing on quality patient care.
With the Quality Payment Program set to begin on January 1, 2017, CMS recently announced it will allow physicians to choose from multiple options during the first performance period. Below is a brief summary of the four options:
Option 1 (Test the Program): As long as you submit some data to the Quality Payment Program after January 1, 2017, you will avoid a negative payment adjustment.
Option 2 (Limited Participation): Submit data to the Quality Payment Program for a reduced number of days (i.e. part of the calendar year), and your practice could still qualify for a small positive payment adjustment.
Option 3 (Full Year Participation): If your practice is ready to go on January 1, 2017, you can submit data to the Quality Payment Program for the full calendar year, and your practice could qualify for a modest positive payment adjustment.
Option 4 (Advanced Alternative Payment Model): You can participate in an Advanced Alternative Payment Model, such as Medicare Shared Savings Track 2 or 3, in lieu of reporting quality data to the Quality Payment Program. If you receive enough of your Medicare payments through this model, you would qualify for a 5 percent incentive payment in 2019.
All of these options and other supporting details will be described in full detail by CMS when the final rule is released by November 1, 2016.
View the official announcement: Plans for the Quality Payment Program in 2017: Pick Your Pace