What can we expect in the MACRA final rule?

Congress passed MACRA in a bi-partisan (yes it actually can happen!) effort.  The Center for Medicare and Medicaid Services (CMS) released the 900-page proposed rule on April 27, 2016, requesting comments. So what can we learn from the final rule that was released today?

There are a few significant changes from the Proposed Rule - below are three. Pages 20-21 of the Final Rule summarize the changes:

• CMS raised the threshold for mandatory participation, allowing more small practices to be exempted from MIPS.
• CMS stuck to January 1, 2017, as the start of MIPS and labels 2017 a transition year, incorporating its “Go at Your Own Pace” guidance into the Final Rule.
• One of the biggest changes for providers interested in the Advanced APM track is the new MSSP ACO Track 1+ model. This model has lower downside risk than MSSP ACO Tracks 2 and 3 and the Next Generation ACOs but will qualify as an Advanced APM.

The industry can expect more details in the coming months as CMS continues to provide iterative guidance related to the implementation of this massive law. Check back here in a couple of weeks, and I’ll have more thoughts after I read through all 2,398 pages of the Final Rule.

And I thought I’d have nothing to read this weekend!

Gretchen Mills is manager of market strategy for populations and payment solutions at 3M Health Information Systems.