"By adopting this thoughtful and flexible approach, the Administration is encouraging a successful transition to the new law by offering physicians options for participating in MACRA,” noted the association in September, as HCB News reported at the time. “This approach better reflects the diversity of medical practices throughout the country.”

AMA noted in its statement to its membership about the recent MACRA announcement that it would “now pore over and dissect the final regulations in the coming days to make sure you know exactly what the rule contains and how it will impact your practice.”

The AMA Wire also noted that CMS “took physician input into consideration, announcing changes that will help physicians make the transition.”

Three changes included are:

• There is no penalty, or negative payment adjustment, for physicians if “they choose one of four participation options in 2017. The takeaway: even minimal performance reporting will exempt you from any penalties, and opportunities for a shorter, 90-day reporting period will make you eligible for positive payment adjustments.”


• No reporting at all for low-volume practices that receive less than $30,000 in Medicare payments or have fewer than 100 Medicare patients.


• In the merit-based incentive payment system (MIPS), one of its four components, resource use, will have a 0 percent weighting toward MIPS score in the first year.

When the payment scheme proposal was put forward in May, a JAMA commentary reported by HCB News at the time, by Dr. Jeffrey Clough of the Duke Clinical Research Institute and Dr. Mark McClellan, director of the Duke-Margolis Center for Health Policy, urged physicians to understand the changes — and opportunities — arising from the new payment scheme in the Medicare Access and CHIP Reauthorization Act (MACRA).

“Their leadership is essential to the future of high-value health care,” noted Clough.

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