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Act now to avoid a 4 percent Medicare penalty in 2019 (Spoiler alert: It’s easy!)

October 27, 2017
Area(s) of Interest: Payor Issues and Reimbursement 


This is the first year physicians need to report on quality measures under the new Quality Payment Program (QPP) from the Centers for Medicare and Medicaid Services (CMS). Eligible professionals who fail to report in 2017 face a 4 percent payment penalty in 2019. But did you know that physicians only need to report on one quality measure for one patient during 2017 in order to avoid a payment penalty in 2019?


During the 2017 transition year, CMS will allow physicians to select one of three “pick your pace” participation options. Participating at any level in 2017 will ensure that you will not be hit with the 4 percent pay cut in 2019.


The most lenient participation option—reporting on one measure for one patient—allows physicians to avoid a penalty by "testing" the program to ensure that their systems are working and that they are prepared for broader implementation in 2018 and beyond.


The American Medical Association (AMA) has published a video, “One patient, one measure, no penalty: How to avoid a Medicare payment penalty with basic reporting,” with step-by-step instructions on how to report so physicians can avoid a negative 4 percent payment adjustment in 2019.


The California Medical Association (CMA) has also published a MACRA resources page to help physicians understand the new payment reforms and what they can do now to start preparing for the transition. Also available in the CMA MACRA resource center is an overview of MACRA, and a comprehensive list of tools, resources and information from CMA, AMA and CMS.

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