To clear up some confusion about the proposed rule, does it retain the first year’s “pick your pace” participation options?
Darryl Drevna: No, CMS is not offering a pick your pace option this year. So unless you’re otherwise excluded, you need to participate fully. For quality, for example, in this performance year you get to submit one quality measure and be held harmless and that’s not the case (for 2018). You can actually submit the full six measures for a 12-month performance period.
Chet Speed: The way they handled the small practice issue was, instead of doing pick your pace part two, they just excluded a vast swath of small practice providers.
Your reaction to the proposed rule seems to be largely negative. What parts of it do you like?
Chet Speed: That’s a good question. What pleases us is MACRA remains a value-based mechanism. Value will be incentivized, albeit slower than we like, but MACRA still remains the law of the land. At some point and time, we will need to move toward value, and MACRA is going to be that mechanism to do it.