The Medicare Access and CHIP Reauthorization Act (MACRA) was passed by Congress and signed into law in 2015. This historic bipartisan legislation substantially supports the much-needed transition from the current volume-driven, fee-for-service (FFS) reimbursement model, to a value-based system that rewards quality and value of care over volume of services provided. MACRA included several provisions, some of which include:
On April 27, 2016, the Centers for Medicare and Medicaid Services (CMS) announced a proposed rule (summarized in this news release), which outlines how CMS proposes to implement the law, including details regarding MIPS and APMs. This proposed rule provides an opportunity to help shape the details of the law's implementation, and the PCPCC will respond before the June 27 deadline with strong comments to support advanced primary care. (Note: PCPCC's comments will be published on our advocacy webpage once submitted to CMS.)
Although the major provisions of MACRA begin in 2019, providers should prepare now because Medicare will use 2017 performance data for payment in 2019.
The U.S. Department of Health and Human Services offers an easy-to-understand video to help explain the complex regulation that is MACRA:
The MACRA makes three important changes to how Medicare pays those who provide care to Medicare beneficiaries:
These changes create a Quality Payment Program (QPP).
On June 27, 2016, the PCPCC submitted its official comments to CMS on the MACRA proposed rule, which are summarized in a June 28 press release.
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Eager to Learn More?
Listen to Washington DC-based health care policy analyst and researcher David Introcaso's Healthcare Policy Podcast, "How CMS Proposed to Annually Update Medicare Physician Reimbursement Under MACRA: A Conversation with Mara McDermott."
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Date![]() |
Source | |
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Slides: How SGR repeal will change Medicare physician payments | April 2015 | The Advisory Board |
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Pediatricians Applaud Passage of Medicare Access and CHIP Reauthorization Act:Statement of Support | April 2015 | American Academy of Pediatrics |
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AOA Letter of Support -- HR 2 Medicare Access and CHIP Reauthorization ACT | March 2015 | American Osteopathic Association |
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SGR Repeal and Medicare Provider Payment Modernization Act:Section by section | March 2015 | House Committee on Ways and Means |
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Healthcare and the 114th Congress: A Dynamic Guide to the Top Issues Affecting Internal Medicine Specialists and Their Patients:Summary of ACP’s Recommendations to Congress | March 2015 | American College of Physicians |