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    Small practices get relief in final MACRA rule


    In announcing the final rule Andy Slavitt, acting administrator for the Centers for Medicare & Medicaid Services (CMS), said the agency received more than 4,000 comments during the rule’s development process. The comments could be summarized, he said, as “make the transition to MACRA as simple and as flexible as possible.” As part of its response, he said, CMS has launched a new website—qpp.cms.gov—to be a “one-stop shop” for helping physicians understand and participate in the quality payment program.

    Slavitt noted that the final rule includes $100 million over five years to help practices with 15 or fewer providers or in underserved areas learn about MACRA and report their data. He added that CMS will continue to take comments on the rule, “so that we can make sure the program evolves as the healthcare system evolves."


    Hot topic: Why physician burnout happens and what we can do to prevent it


    In another potentially significant change from the earlier version of the MACRA rule, CMS says it is mulling development of a new alternative payment model for launch in 2018. The new model, called ACO Track 1+, would entail less risk than the alternative models that currently qualify for the quality payment program.

    CMS predicts that the increased flexibility in reporting options of the final rule as compared with the earlier version, along with other policy changes will lead to small practices participating in the quality payment program at rates close to those of larger practices—a significant change from its earlier estimates.

    In addition, the agency is forecasting that about 90% of MIPS-eligible providers, and 80% of those in solo or small practices, will either see no change in their Medicare reimbursements or receive a bonus. 

    Next: Industry reacts

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    • [email protected]
      As a family practice doc in a 2 person practice, I find the definition of a "small practice" absurd. Less than 100 Medicare patients means one practices pediatrics or in a college environment. At age 59, I am getting out now before I am forced to be employed by a hospital, or work under the single payer system that is down the road. My advice to the new practitioner under the new rules is to return to the old days and not accept ANY insurance or Medicare; only cash. One day they will be the only way patients get to see a MD/DO for frontline health care, and many will be willing to pay for that "privilege"

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