The Centers for Medicare & Medicaid Services may delay implementation of Medicare payment reforms over concerns that some physicians may not be prepared for them.

The Medicare Access and CHIP Reauthorization Act of 2015 was passed to replace the much maligned sustainable growth-rate formula, which had threatened funding havoc for long-term care providers and other sectors for numerous years.

Speaking before the Senate Finance Committee on Wednesday, CMS Acting Administrator Andy Slavitt said the agency is considering pushing MACRA’s start date back from Jan. 1, 2017.

Several healthcare groups have urged CMS to delay the start to account for rural physicians or those small practices who might not be ready to meet MACRA requirements. There are also concerns about how the new regulations would affect elderly patients.

“Some of the things that are on the table, [that] we’re considering include alternative start dates, looking at whether shorter periods could be used, and finding other ways for physicians to get experience with the program before the impact of it really hits them,” Slavitt told the committee.

In addition to the new physician regulations, CMS is turning its focus to reimbursement rates for patients with chronic conditions, and more alternative payment models like bundling and prevention-based programs, Slavitt said.