CMS: Small, rural practices can ‘soon’ apply for $100M in technical MACRA assistance

Seeking to ease the fears for small and rural practices of being penalized under the new Merit-based Incentive Payment System (MIPS), CMS plans to soon release its request for proposals for the $100 million in technical assistance provided for those practices in 2015’s Medicare Access and CHIP Reauthorization Act (MACRA).

Speaking at an Alliance for Health Reform event May 20, CMS’ clinical quality director, Kate Goodrich, said it will be taking requests for the funding “relatively soon,” according to POLITICO.

CMS’ own data in the proposed MACRA rule said clinicians in groups of 24 or less would be penalized as underperforming under MIPS beginning in 2019, when penalties would be capped as high or low as 4 percent of Medicare fee-for-service revenue. The smaller the practice, the higher the chances were for negative adjustment: 59.4 percent for practices of 10-24 clinicians, 69.9 percent for 2-9 clinicians, and 87 percent for solo practices.

Since then, CMS has focused on making smaller practices less frightened by the transition. CMS’ acting director Andy Slavitt testified at a congressional hearing that the agency based its estimates on 2014 Medicare incentive programs, which may not reflect how physicians will respond to MIPS.

“Our data shows that physicians in small and solo practices can do just as well and actually do just as well as physicians in practices that are larger,” Slavitt said.

CMS has also released a fact sheet outlining the “flexibilities” for small practices under MACRA, including excluding clinicians and groups with less than or equal to $10,000 in Medicare charges and below 100 Medicare patients from MIPS payment adjustment. It also allows for solo and small practices to join “virtual groups” for the purposes of MIPS reporting.