As referenced in Modern Healthcare (and nearly every healthcare publication….) on Wednesday, July 13th, CMS Acting Administrator Andy Slavitt informed lawmakers of the possible delay to the January 1st start date for Medicare payment reform. Testifying before the Senate Finance Committee, Slavitt expressed concern for small practice physicians, who may not be ready for the changes under the Medicare Access and CHIP Reauthorization Act. Support for the possible delay also comes from the American Medical Association, American Academy of Family Physicians, and the Medical Group Management Association. Those who will most likely celebrate this push are small and rural practices, who may be forced to join hospitals or larger practices because of the payment changes and paperwork; which Slavitt and CMS are well aware of and are also concerned about. Pushing the start date is not the only change being considered, as they are also looking at whether shorter reporting periods could be utilized, possible higher reimbursement rates for physicians with chronic condition patients, and ways for physicians to get experience with a program before “the impact really hits them”. The president of the American Academy of Family Physicians, Dr. Wanda Filer, prefers if the MACRA start date gets pushed to “no earlier than July of next year or January 2018.” Will CMS halt the changes until 2018? Or will it start in 2017, with possible loss of small practices? We’ll have to stay tuned for how this plays out.