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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BREAKING: Slavitt Suggests MACRA Could Be Delayed | Modern Healthcare | July 13, 2016 |
Here Are the MACRA Questions Every Healthcare Provider Must Ask | Healthcare Finance News | July 18, 2016 |
Alternative Payment Model Could be Saving Grace for Quality Improvement | Medical Economics | July 18, 2016 |
CMS Heeds Concerns, Allows ACOs to Join CPC+ | Medical Economics | July 18, 2016 |
Enter MACRA:CMS Chief Andy Slavitt Says New Law Lets Doctors be Doctors | Healthcare Finance News | July 18, 2016 |
CMS Needs to Halt the March to Health Care Gigantism | The Hill | July 22, 2016 |
CMS Chief Andy Slavitt Again Floats Possible MACRA Delay | Healthcare Finance News | July 25, 2016 |
Slavitt: ‘We’ll Go as Fast as the Evidence Allows Us to Go’ | Modern Healthcare | July 30, 2016 |
ACO Participation Prepares FPs for MACRA Implementation | AAFP News | August 2, 2016 |
MACRA Matters Affecting Rural Providers | RACMonitor | August 3, 2016 |