An Introduction to MACRA

The Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) was signed into law on April 16, 2015. The law outlines many initiatives, but it primarily establishes new ways to pay physicians who care for Medicare Part B beneficiaries. This comprehensive legislation has the potential to significantly restructure the country’s healthcare system.

The Federal Department of Health and Human Services (HHS) and the Centers for Medicare & Medicaid Services (CMS) have been drafting rules based on the legislation since the law passed. The drafted rules are intended to provide the working guidelines for MACRA implementation, and they are currently in the comment period, which runs through September. The rules will then be revised and finalized for release and implementation in November. 

A growing percentage of physician payment will be based on value, not on volume like the current fee-for-service system. To pay for value, it must be defined and indicators (or measures) of good care will be selected to evaluate performance. MACRA’s value-based payment programs will be based on two new reimbursement structures: the Merit-Based Incentive Payments System (MIPS) and Alternative Payment Models (APMs).

Defining common measures may enable better care at lower cost. MACRA provides an opportunity to improve reporting accuracy and effectiveness, leading to reduced waste.

These changes will determine payment starting in 2019, so it’s recommended that physicians learn all they can now and stay up-to-date on the latest information to be successful in the new environment.

To learn more about MACRA, click here for the AMCNO’s web page on the topic. This page also contains links to other organizations that have created web pages dedicated specifically to MACRA. 

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