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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Source | Date |
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CMS Details MACRA, MIPS Accountable Care Quality Metrics | Health IT Analytics | December 22, 2015 |
100+ Medical Organizations Urge Changes to Proposed Rule | AAFP News | July 1, 2016 |
5 initial reactions to the proposed MACRA rule | Becker's Hospital Review | April 29, 2016 |
9 major takeaways from the 2018 MACRA proposed rule | Healthcare Dive | June 26, 2017 |
A look at key parts of sweeping bill changing how Medicare pays doctors | Los Angeles Times | April 15, 2015 |
AAFP Declares Victory for FPs as Senate Fully Repeals SGR | AAFP News | April 15, 2015 |
AAFP Expends Huge Effort to Shape New Payment System | AAFP News | November 17, 2015 |
AAFP Fires Off Recommended Changes to 2016 Proposed Medicare Physician Fee Schedule | AAFP News | September 2, 2015 |
Accountable care organizations need stronger federal support:Whitepaper: Risk, MACRA exclusion have ACOs at 'crossroads' | Fierce Healthcare | June 3, 2016 |
ACO Participation Prepares FPs for MACRA Implementation | AAFP News | August 2, 2016 |