MACRA final rule has critical info for you

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November 04, 2016
Welcome to The ACP Advocate,

All of today's articles are devoted to a single, critical topic for you: The MACRA final rule.

Released in mid-October, the final rule consists of nearly 2,500 pages and ushers in a new era of Medicare reimbursement reform. It lays out how CMS intends to implement its new Quality Payment Program (QPP), which will link traditional Medicare payments to measurements of quality, use of electronic health records, and practice improvement activities, or alternatively reward physicians who participate in advanced Alternative Payment Models that accept financial risk.

Today's first article is an overview of the final rule and on how CMS made numerous improvements from its earlier proposal rule, resulting in important wins for ACP advocacy, and most importantly, for our members.

The second article explains how CMS proposes to implement a "pick your pace" plan that lets physicians choose the time frame for transitioning to the new system that works best for them--another important victory, especially for smaller practices.

Today's final article looks at how there's less risk and more options for physicians who are ready to participate in an Alternative Payment Model (APM), allowing them to qualify for Medicare Fee for Service (FFS) bonus payments while creating opportunities for additional revenue for achieving savings or quality improvements.

The next ACP Advocate newsletter will be distributed on Nov. 18. One of the scheduled articles will cover the newly released Physician Fee Schedule and Hospital Outpatient Prospective Payment System and how they will benefit ACP members. We'll also look at the latest ACA open-enrollment period that began earlier this week and some of the post-election implications.
For more coverage of what's happening in Washington, take a look at my award-winning blog, The ACP Advocate Blog by Bob Doherty. You can also follow me on Twitter @BobDohertyACP.

As always, please send your feedback and suggestions on this newsletter to:

Yours truly,

Bob Doherty
Senior Vice President
Governmental Affairs and Public Policy
American College of Physicians

In the news
» Medicare Releases Final Rule on Medicare Payment Programs

Changes applauded by ACP as victory for physicians and College advocacy

The newly issued regulations that will guide implementation of Medicare's new physician payment program -- the so-called "final rule" on MACRA, the Medicare Access and CHIP Reauthorization Act -- have found f... (read more)

» CMS Offers Options for Initiating Participation in New Payment Program

'Pick your pace' plan lets physicians choose method that 'makes sense for them,' ACP says

Physicians who aren't certain they're ready to fully participate in Medicare's new Quality Payment Program have gotten a bit of a break from the Centers for Medicare and Medicaid Services.

The progr... (read more)

» Less Risk, More Options for APMs Welcomed by ACP

Changes will also affect available tracks and medical home participation

Reducing the risk and increasing the options awaiting physician practices that are interested in the advanced Alternative Payment Model (APM) path in Medicare's new physician reimbursement program are conside... (read more)

About this newsletter
The ACP Advocate is an e-newsletter, edited by the College's Washington, DC governmental affairs division, created to provide you, our members, with succinct news about public policy issues affecting internal medicine and patient care. To learn more about ACP's Advocacy and to access the ACP Advocate archives, go to
In this issue
» Medicare Releases Final Rule on Medicare Payment Programs
» CMS Offers Options for Initiating Participation in New Payment Program
» Less Risk, More Options for APMs Welcomed by ACP

In focus
» Health care Twitter chat on elections: Nov. 10
Join Bob Doherty (, ACP's senior vice president for governmental affairs and public policy, and ACP's Council of Resident/Fellow Members for a Twitter chat on Thurs., Nov. 10, from 12-1 p.m. ET about health care policy as it pertains to the newly elected President and Congress. Join the conversation by using hashtag #ACPCRFM.
» MACRA discussion forums for physicians
Interested in discussing MACRA with your colleagues and ACP staff? Subscribe to the ACP Member Forum dedicated to MACRA. This forum is for ACP members to discuss the new MACRA legislation and the subsequent Quality Payment Program, as well as other related issues like making strategic changes to successfully care for patients in the growing value-based payment environment.
» ACP open enrollment resources
ACP has developed materials to help your patients shop for and enroll in marketplace-based health insurance during the 2017 open enrollment season. 13.8 million individuals are expected to sign up for coverage through the Marketplaces during the Nov. 1, 2016 through Jan. 31, 2017 Open Enrollment period, HHS Secretary Sylvia M. Burwell says. ACP's patient assistance resources are available online, and patients can visit or call 1-800-318-2596 for enrollment assistance.
» CMS Updates -- PQRS and QRURs
CMS recently released the Physician Quality Reporting System (PQRS) Feedback Reports and Quality and Resource Use Reports (QRURs) for calendar year 2015. These reports show 2015 program results for PQRS and Value Modifier programs and are now available for review to determine whether physicians are subject to the 2017 PQRS negative payment adjustment and the 2017 Value Modifier payment adjustment. Solo physicians and physician groups have through Nov. 30, 2016, to submit an informal review if they believe they were assessed incorrectly.

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