The American College of Physicians (ACP) Statement on CMS Outline of Positive Changes to MACRA

Attributable to:
Nitin S. Damle, MD, MS, FACP
President, American College of Physicians (ACP)

The Centers for Medicare and Medicaid Services (CMS) announced on Sept. 8 that it would make changes to the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) regulation allowing physicians more flexibility and reporting options for the Quality Payment Program. The CMS announcement was published in a CMS blog post yesterday afternoon.

The American College of Physicians is pleased that CMS plans to implement changes to give physicians more options to participate in the Quality Payment Program in 2017 without being at risk of negative adjustments.  These changes are consistent with recommendations made by ACP and other physician stakeholders to exempt small practices from negative adjustments and to provide more flexible options for practices of all sizes to be successful.

CMS intends for the Quality Payment Program to allow physicians to pick their pace of participation for the first performance period that begins January 1, 2017. During 2017, eligible physicians and other clinicians will have multiple options for participation. Choosing one of these reporting options would ensure practices do not receive a negative payment adjustment in 2019. Thus, the minimal reporting option will also allow for a longer transition period for those practices that still need time to adjust for the new MACRA performance requirements without being at risk of negative adjustments, while other practices that are able to more fully participate in 2017, for some or all of the year, could qualify for “small” to “modest” positive adjustments.

These options and other supporting details will be described fully in the final rule, according to CMS.  ACP is currently reviewing the CMS announcement and will soon provide a more detailed overview.

It is important to note that this announcement does not delay the initial performance period of MACRA; some level of participation would be required for each of the options in order for a practice to not be subjected to negative adjustments. However, it provides the time and flexibility needed for those practices to choose the pace of their participation, while allowing those who are ready to report beginning January 1, 2017 to be eligible for a positive payment adjustment.

We look forward to working with CMS to ensure a smooth transition as implementation continues to move forward.


The American College of Physicians is the largest medical specialty organization and the second-largest physician group in the United States. ACP members include 148,000 internal medicine physicians (internists), related subspecialists, and medical students. Internal medicine physicians are specialists who apply scientific knowledge and clinical expertise to the diagnosis, treatment, and compassionate care of adults across the spectrum from health to complex illness. Follow ACP on Twitter and Facebook.

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