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Highlights from the 2018 proposed MACRA rule

Centers for Medicare & Medicaid Services has published the proposed MACRA rule for 2018. Yes, you read that right, 2018. We know many of you are still getting your arms wrapped around the 2017 program, but here is a summary published in the AMA Wire of some of the most significant changes proposed for next year.

Changes to the eligibility criteria exclude more providers and practices: The proposed rule raises the eligibility threshold to $90,000 a year in Medicare Part B billing or 200 Medicare-enrolled patients. The proposed rule also makes it easier for practices with up to 15 physicians to adhere to the guidelines or skip participation all together.

Although the changes could allow more practices to skip MACRA for the time being, we encourage LHP members to take a long-term view when deciding whether to participate. The participation threshold will fluctuate over the next few years, but it is likely that eventually CMS will require more practices to participate in MACRA. Also, the addition of other payors to the program in future years will make MACRA more relevant to practices that don’t currently meet the participation threshold. Participating in the program now, even if your practice doesn’t meet the threshold, may set you up for success in the future.

The performance period is increased: In 2018, participating practices and providers in the MIPS track will be required to report Quality data for a 12-month period, and Advancing Care Information and Improvement Activities data for 90-day periods. This is a shift from the “pick your pace” policy for 2017.

The cost category remains weighted at zero:
For 2018, performance in the cost category will not impact participant scores. However, the MACRA legislation mandates that performance on cost will comprise 30 percent of the MACRA by 2019, a requirement that is unlikely to change. This means that participants should pay close attention to how they perform on cost in 2017 and 2018 even if it doesn’t impact their results because the next year it will have a significant impact on performance scores and the resulting payment adjustments.

Members prepare for 2017 participation at the LHP MACRA Forum

On June 19, Legacy Health Partners providers and practice administrators attended the first Legacy Health Partner MACRA Forum. It was an interactive event featuring a lot of dialogue and knowledge sharing between LHP staff and members and the feedback from attendees has been positive. LHP members also had the opportunity to learn more about the services provided by Legacy and LHP to support them with MACRA.

The issues that are top of mind for members based on the discussions at the event include: what the changes to the 2017 and 2018 rules mean for who is required to participate, how participants can maximize their score to receive the best payment adjustment possible from CMS, and how to assess the return on investment for MACRA participation.

A recent survey published in Modern Healthcare by the American Medical Association and consulting firm KPMG found that fewer than one in four providers are prepared to meet the MACRA requirements in 2017. The LHP staff is committed to helping members navigate this program successfully, whether it is through Legacy Partner Solutions that help offload the burden of participating, or providing educational resources such as the LHP MACRA Forum.

Materials from the MACRA Forum are available on the LHP team site (available to LHP members only). 


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