You may have seen a headline or two last week stating that the Centers for Medicare & Medicaid Services (CMS) may delay MACRA’s effective date. However, the agency has not announced any such delay. Instead, CMS’ top official indicated the agency is considering some adjustments to the initial performance period.
The U.S. Senate Finance Committee held a hearing on MACRA last week, and CMS Acting Administrator Andy Slavitt was called upon to testify. In his prepared remarks, Slavitt highlighted CMS’ outreach activities, beginning last year, intended to inform the rulemaking process, but never used the word “delay.” Instead, during questioning, Senator Orrin Hatch (R-Utah), the committee chair, noted that many physician groups have been calling for a six-month delay, and stated that the statute gives CMS the flexibility to move the start date for the reporting period back. In response, Slavitt acknowledged that CMS had received significant feedback on this point, and that the agency remained open to the option of an alternative start date and shorter performance period.
In the proposed rule, CMS has stated the initial performance period will be January 1, 2017, to December 31, 2017. Physicians then will report on their 2017 performance on the MACRA measures during the first part of 2018. CMS will announce individual physician composite performance scores in late 2018. Then, starting January 1, 2019, physicians’ Medicare payments will be adjusted based on those composite performance scores.
The potential delay discussed during the committee hearing last week would mean a shortening of the initial performance period. Instead of measuring performance for the entirety of 2017, CMS may elect to measure only the last six months, for example. That would afford physicians extra time to identify relevant measures, focus on performance improvement, and figure out reporting mechanisms. But it would not delay the release of the first round of composite performance scores or the start of payment adjustments January 1, 2019.
In light of this, providers should continue preparing for MACRA, rather than merely hoping it will go away. Right now, the focus should be on education—helping physicians understand how MACRA works and the impact on their practices—and strategies for maximizing their composite performance scores.