Pick Your Pace in the Quality Payment Race

Pick Your Pace in the Quality Payment Race

As the saying goes, “it’s not a sprint, it’s a marathon,” and the Centers for Medicare & Medicaid Services (CMS) seems to agree. January 1st marks the beginning of the Quality Payment Program (QPP), a unified framework that will  implement key provisions to the Medicare Access and Summary CHIP Reauthorization Act of 2015 (MACRA).  This new program repeals the Sustainable Growth Rate formula and provides opportunities for physicians and other clinicians to earn more by focusing on quality patient care. Because of the wide diversity of physician practices, CMS has decided to allow physicians to “pick their pace” of participation for the first performance period of QPP (Note: the final rule will be released by November 1, 2016).

Your four route options outlined by Andy Slavitt in the official CMS blog:

#1: Slow but Steady

“With this option, as long as you submit some data to the Quality Payment Program, including data from after January 1, 2017, you will avoid a negative payment adjustment. This first option is designed to ensure that your system is working and that you are prepared for broader participation in 2018 and 2019 as you learn more.” 

#2: Picking up the pace

“You may choose to submit Quality Payment Program information for a reduced number of days. This means your first performance period could begin later than January 1, 2017 and your practice could still qualify for a small positive payment adjustment”

#3: Shooting for a PR

“For practices that are ready to go on January 1, 2017, you may choose to submit Quality Payment Program information for a full calendar year. This means your first performance period would begin on January 1, 2017.”

#4: Running with the Elites

“Instead of reporting quality data and other information, the law allows you to participate in the Quality Payment Program by joining an Advanced Alternative Payment Model, such as Medicare Shared Savings Track 2 or 3 in 2017.  If you receive enough of your Medicare payments or see enough of your Medicare patients through the Advanced Alternative Payment Model in 2017, then you would qualify for a 5 percent incentive payment in 2019.”

Many organizations and providers are already demonstrating the elements required in MIPS (Options #1-3).  For example, providers participating in qualified Patient Centered Medical Homes will have a significant advantage in maximizing MACRA payments. If your organization is considering adopting a PCMH model, this could be the extra incentive needed to tip the scales.  To learn more about PCMHs, make sure to watch our webcast series on YouTube.

Download our PCMH Playbook.

So whether you want to hit the ground running or save your stamina, choosing one of these routes guarantees success.  As stated by Slavitt, if you choose any of the four options it will “ensure you do not receive a negative payment adjustment in 2019.”

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