Issue link: https://beckershealthcare.uberflip.com/i/731691
70 CFO / FINANCE CMS Says Providers Can 'Pick Their Pace' for MACRA: 6 Things to Know By Akanksha Jayanthi C MS is offering flexibility to providers participating in the Quality Payment Program under the Medicare Access and CHIP Reauthorization Act, outlining multi- ple options as to how they can participate in the first year. e Quality Payment Program, which refers to the Merit-based Incentive Payment System and Advanced Alternative Payment Models, is set to begin Jan. 1, and for the first performance pe- riod — calendar year 2017 — eligible providers can select one of four options for participation that would ensure they do not receive a negative payment adjustment in 2019. Here are six things to know about the options for first-year participation. 1. e four proposed options offer different lev- els of participation in the Quality Payment Pro- gram in 2017, ranging from submitting "some data" to fully participating in an Advanced Al- ternative Payment Model. CMS says it wants to allow providers to participate in the program at a speed with which they are comfortable, at least for the first year. "We intend for the Quality Pay- ment Program to allow physicians to pick their pace of participation for the first performance period," Andy Slavitt, acting administrator of CMS, said in a blog post. 2. e first option allows providers to "test" the Quality Payment Program. If providers submit "some data" to the Quality Payment Program from aer Jan. 1, they will avoid a negative pay- ment adjustment in 2019. "is first option is designed to ensure that your system is working and that you are prepared for broader partici- pation in 2018 and 2019 as you learn more," ac- cording to the post. 3. e second option permits providers to par- ticipate in the program for part of the calendar year. Providers who pursue the second option can submit quality measure and improvement activity data required under the Quality Pay- ment Program for a reduced number of days and still qualify for a small positive payment adjustment. 4. e third option is geared toward organi- zations ready to fully participate and submit Quality Payment Program information for the full calendar year. Such organizations could qualify for a "modest" positive payment adjustment. "We've seen physician practices of all sizes successfully submit a full year's quality data and expect many will be ready to do so," Mr. Slavitt wrote in the post. 5. Finally, providers can choose to participate in an Advanced Alternative Payment Model in 2017, like a Medicare Shared Savings Program Track 2 or 3 accountable care organization. Qualifying Advanced Alternative Payment Models have yet to be determined under the final rule. Providers who are successful in these alternative payment models could qualify for a 5 percent incentive payment in 2019. 6. Mr. Slavitt writes CMS will release the fi- nal rule by Nov. 1, and the final rule will con- tain more details and further address concerns voiced by providers, such as burdens of excessive reporting, unique issues facing small and rural, non-hospital-based physicians and how tech- nology can help patient care. "However you choose to participate in 2017, we will have resources available to assist you and walk you through whatever needs to be done," Mr. Slavitt wrote. "And however you choose to participate, your feedback will be invaluable to building this program for the long-term to achieve the outcomes that matter to your patients." n Dartmouth-Hitchcock to Lay Off Up to 460 Employees By Ayla Ellison L ebanon, N.H.-based Dartmouth-Hitchcock will lay off be- tween 270 and 460 employees by the end of 2016, accord- ing to the Concord Monitor. Dartmouth-Hitchcock employees were told Aug. 9 about the planned layoffs in a memo from system President and CEO James Weinstein, DO. According to the memo, the system is trying to cut costs after closing the fiscal year that ended June 30 with an unexpected $12 million deficit. It is unclear which service areas will be affected by the cuts. Dart- mouth-Hitchcock will provide more details about its layoff plans in mid-October after a review of its clinical programs. "Services will be evaluated, not just through the lens of whether they are financially beneficial, but also in terms of how they contribute to our patient care, research and education missions," according to the memo from Dr. Weinstein published by the Valley News. The health system's workforce is expected to be reduced by 3 to 5 percent. As of June, Dartmouth-Hitchcock had 9,239 workers, according to the Valley News. n Cleveland Clinic's Operating Margin Slips in First Half of 2016 By Ayla Ellison C leveland Clinic ended the first half of this year with an operating margin of 1.2 per- cent, compared with a 5.6 percent operat- ing margin in the same period of last year. The 13-hospital system recorded revenue of $3.9 billion in the six-month period that ended June 30, up 16.6 percent from the same period of 2015. That financial boost was largely attributable to an increase in patient service revenue. However, rising expenses offset revenue gains. Cleveland Clinic saw a 22.5 percent year-over-year increase in expenses, as labor, supplies and phar- maceutical costs grew. The system ended the first half of this year with operating income of $47.7 million, down from an operating income of $188.5 million in the same period of the year prior. n