3 days ago, CMS released the proposed changes to MACRA.  I’m sure each of you have time to read all 1,052 pages, because, well, it’s just a good read. Right?

But, if you’re like most, you haven’t had time, so let’s take a quick look at the proposed 2018 MACRA changes.

  • WHAT’S THE NEW PROPOSED RULE ALL ABOUT?  CMS appears to be looking out for the smaller practices by proposing those participating in MIPS be exempt by changing their low-volume threshold to $90,000 or less, OR, 200 or less Medicare patients annually.  If the estimate on the number of small practices this involves is right, this is great news for over 130,000 Providers!
  • WHY IS CMS RELEASING SUCH A PROPOSAL?  Could it be that CMS is looking out for the smaller provider by allowing more time to prepare for reporting and reducing administrative burdens? If successful, this would allow the provider to concentrate on patient care, right? It seems as though the concerns of the medical community have been heard, as discontentment has been voiced stating the burdensome paperwork required does take away from quality patient care which is (in essence) defeating the whole purpose of MACRA’s core purpose being Value-Based Care! AMA’s President, David Barbe states “This flexible approach will give physicians more options to participate in MACRA and takes into consideration the diversity of medical practices throughout the country.”

CMS didn’t stop there.  Other added proposals include:

  • The creation of Virtual Groups which would allow small practices to combine their administrative costs by working with other small practices
  • Small practices could receive extra bonus points within the Composite Performance Score for MIPS to recognize their value to the areas in which they serve
  • How about adding the option for providers to use facility-based scoring for like clinicians such as hospitalists
  • And, continuation of the “at your own pace” option for implementation of MIPS data reporting in 2018.  This would allow for the continuing usage of the 2014-edition of Certified Electronic Health Record Technology
  • Providers in small practices would have a new hardship exemption in the advancing care information data-reporting category

CMS further states, this proposed rule predicts that 80% of small practices will receive a positive or neutral payment adjustment.

CAUTION: While the proposed rule certainly offers some relief, it doesn’t make things go away.  Small practices will still have significant investments to make, in order to comply with MACRA.

As your MEDICAL BILLING SERVICE, MBO will continue to keep you updated on these hot topics as they become available.

Call us at 573.634.7155 and let’s talk about how we can team up, work together and avoid any negative adjustments in your reimbursement.