Dr Kate Goodrich Outlines the 'Pick Your Pace' Aspect of MACRA

To create flexibility during the transition to the payment system under the Medicare Access and CHIP Reauthorization Act (MACRA), CMS has created something called “pick your pace,” explained Kate Goodrich, MD, director of the Quality Measurement and Value-Based Incentives Group in CMS.
What flexibilities were built into the MACRA final rule to help ease transition?
We initiated something called “pick your pace.” And pick your pace allows you to essentially choose 1 of 4 options. First, you can, if you have a new system or you just want to test out how you can do in submitting data to us, you just have to send in a single measure. It can be a quality measure, it can be an improvement activity, or it can be 4 required measures under the advancing care information category. You can do 1; you can do 4. You can do any amount that you want. But in order to avoid a penalty, you just have to do 1. You won’t get a bonus either if just 1—you’ll really be at neutral—but at least you’ll avoid a penalty.
Number 2: you can choose to report data for about 90 days on any of the categories or all 3 of the categories. And under that system, if you report data for 90 days for quality, for cost, and for advancing care information, you will either have no change in your payment, or you may even get a slight bonus.
And finally, you can fully participate for a year, as many practices are doing now. We know that about 62% of eligible clinicians participate in the current PQRS [Physician Quality Reporting System]. So we know that a lot of folks do feel ready for 1 year. And we anticipate that those folks will get a little bit higher of a bonus. Up to probably close to 3% or so.
Now if you participate for 90 days and you meet all of the requirement for the measures—6 measures in quality, up to 4 measures in improvement activities, and, of course, advancing care information—you could also get a higher bonus. So there’s nothing magical about a full year compared to 90 days in and of itself. We just know that people are more likely to have more reliable data that can be scored if they report more of it.
And then, finally, your fourth option is to participate in an advanced APM [alternative payment model], where then you would actually be exempt from the MIPS program potentially, if you meet a certain threshold of payments or patients through that advanced APM. And you would be eligible to receive the 5% incentive bonus that is available for people who meet those thresholds, who are in advanced APMs.
So this really allows clinicians to choose how much they want to participate in the first year. Allows them time to gain more familiarity with the program and what is going to be required and what is required, so that by the future years of the program, they will be more prepared to fully participate for a full year.
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