In a continuing dialog with providers on MACRA, Andy Slavitt addressed the American Osteopathic Association at their annual meeting Friday, once again hinting at a possible delay in implementation so that providers, especially smaller practices, have time to prepare.
"Some of the things that are on the table include alternative start dates, looking at whether shorter periods could be used, and finding other ways for physicians to get experience with the program before the impact of it really begins," Slavitt said.
He told the Association that physicians are ready for new, better-functioning program that focuses less on paperwork and reporting, and that many are already participating in elements of MACRA, namely the programs like meaningful use that got rolled into MACRA. Still he said, the new rule constitutes sweeping change and Slavitt said CMS's goal is to make sure physicians are set up for success.
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He said one of the major areas where they've received feedback is the potential impact of MACRA on small and rural practices, noting as he has on other occasions that many of these providers will likely struggle to with implementation due to technology and staffing resource challenges. Slavitt still contends, however, that the rule could work for all, pushing the idea of collaboration.
"We know from experience that small practices can be just as successful as larger practices if the bar to participating isn't too administratively burdensome. We are working directly with physician user groups to listen to how we can design additional ways to make that easier. Even more exciting are opportunities to join new medical home models like our CPC+ model for smaller practices, which will provide fewer reporting requirements, innovative telemedicine opportunities, and qualify for a 5 percent bonus."
This isn't the first time Slavitt has hinted at a possible delay. On July 13 he told the Senate Finance committee CMS is open to "open to multiple approaches" that might ease the transition into the new rule, which is set to take effect January 1, 2017. Metrics from 2017 are slated for use in determining reimbursements for 2019. But since right now, the rule isn't set to be finalized until November, many feel that is far too quick a turnaround for providers to adequately prepare.