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October surprise! MACRA final rule makes an early debut

Posted by Blake McWilliams on 2016-10-14

The folks at CMS surprised everyone today with an earlier than expected release of MACRA’s final rule. Clocking in at nearly 2,400 pages, it sets the stage for a new era of value-based healthcare. In an unusual morning conference call, Dr. Mandy Cohen, CMS’s Chief Operating Officer opened the day by explaining that “the morning release was to keep you on your toes” and that it “was a new day at CMS, day one of a multi-year journey.”

Cohen reaffirmed that at it’s core, MACRA centers focus on the patient and “will pay for what works.” CMS has incorporated 4,000 public comments, and has designed the new rule to start gradually, and that the unveiling of the new CMS Quality Performance Program website during the call should be considered a “down payment,” with many new tools and features planned for the site. Already available on the new site is a Quality Measures “shopping cart” to search for measures by high priority measures, data submission method and specialty measure sets.

Prominent in the new rule is the modification in how different Performance Measures would be weighted in MIPS’s first performance year, 2017, with Quality measures accounting for 60% of a provider’s Composite Performance Score (CPS). Resource Use in 2017 will be weighted at 0%, but will start to count towards CPS computation in 2018. The rule creates the opportunity for clinicians to get a strong start by making MIPS simpler and more streamlined.


The finalized rule also expands the prospective pathways to receive reimbursement payments using Alternative Payment Models (APM) with an arguably aggressive CMS goal of 20 -25% of physicians using some version of APMs by 2018. In addition to current available APM models, it it is expected that other payment models will be retrofitted or reopened for APM status consideration. In response to public comments, CPS is also expected to deliver new APM models that target small and specialty practices.

The call revealed CMS’s plan to rollout a host of tools and resources. If you are willing for a long read, the entire MACRA final rule has been posted on the new CMS QPP website. If reading the 2,398 page rule in its entirety doesn’t suit you, the site also offers a 24 page executive summary that may be more to your liking. The website also features a 12 page overview factsheet.

As CMS Deputy Director Jean Moody-Williams conveyed to those on the call, “the work now begins,” and announced the date of CMS’s first webinar on the final MACRA rule, scheduled for October 26th. She also mentioned a “train the trainer” initiative, with additional information promised to come in the near future.

To find out how OBERD can help you navigate this epic new rule, please email us at info@oberd.com

“The journey of a thousand miles begins with one step.” -Lao Tzu