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."
Title | Source | Date |
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CMS Touts Savings, Quality Under Primary-Care Initiative | Modern Healthcare | October 17, 2016 |
Few Docs Ready for Risk Under MACRA | Modern Healthcare | August 13, 2016 |
Small practices receive $20 million from the CMS to help with MACRA | Modern Healthcare | February 17, 2017 |
Mixed reactions to CMS tool predicting impact of MACRA on providers' bottom line | Modern Healthcare | September 21, 2016 |
Changing how doctors get paid | Modern Healthcare | March 11, 2017 |
Medicare Proposes Paying for End-of-Life Counseling in Sweeping Physician Payment Rule | Modern Healthcare | July 8, 2015 |
Politics may hinder efforts to get more docs into alternative payment models under MACRA | Modern Healthcare | September 15, 2016 |
The forgotten track: Medicare ACOs qualify for third MACRA option | Modern Healthcare | May 26, 2017 |
The missing patient voice in value-based care | Modern Healthcare | May 10, 2016 |
BREAKING: Slavitt Suggests MACRA Could Be Delayed | Modern Healthcare | July 13, 2016 |