Tuesday, December 13, 2016
Pick-Your-Pace Reimbursement Options for Medicare
Dr. Richard Epstein has practiced as an anesthesiologist for more than 30 years. In that time, Dr. Richard Epstein has pursued a personal interest in the economics of medicine and in such processes as the Medicare Access and CHIP Reauthorization Act (MACRA).
MACRA ties Medicare physician reimbursement to outcome and cost of care. This system requires significant reporting by providers, whose end-of-year responsibilities also include a number of other reporting and planning functions. To allow for this complexity, and to support a learning curve for required reporting, the Centers for Medicare and Medicaid Services (CMS) has introduced a four-option plan for first-year data delivery.
The new “pick-your-pace” options include the reporting of “some” data, which would serve as an indication of the practice's participation readiness. This option would allow a practice to avoid a negative adjustment in reimbursement.
A practice may also opt to submit full data for less than a full calendar year, in exchange for a small positive adjustment in payment. A third option is available for those practices that are ready to submit full data for calendar year 2017, while the fourth option reinforces the incentive to participate in the Advanced Alternative Payment Model. Practices that embrace such models will not need to transmit data but will receive a 5 percent incentive as of 2019.