According to a draft rule released this month, CMS is moving up its plan by one year to shift thousands of physicians in mid-sized physician groups into an Affordable Care Act (ACA) program that ties a portion of their Medicare reimbursements to the quality of their care.

Under the ACA, by 2017 nearly 500,000 physicians working in group practices will begin receiving bonuses or penalties based on performance, in an effort reduce health care spending. The ACA requires large-sized physician groups with 100 or more doctors to switch to the new payment system in 2015, under which they could gain or lose as much as 1% of their pay based on realizing certain quality measures. Many of the benchmarks will measure how frequently doctors follow basic medical approaches. The incentives would double, to 2%, in 2016.

Under the draft rule, mid-sized physicians groups of 10 to 99 doctors will now begin the program in 2016, one year earlier than originally scheduled. However, physicians in these groups will be eligible for bonuses up to 2%, but will not face any penalties during the first year. Smaller practices of nine or fewer physicians will begin the program in 2017.