On April 16, 2015, President Obama signed into law the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA), significantly changing the health care financing system for the first time since 1965. The details of these sweeping changes are still being worked out, but all physicians should make plans for the new payment system.
MACRA repealed the Sustainable Growth Rate (SGR) payment system, which governed how physicians were paid under Part B of the Medicare program, and replaced its fee-for-service reimbursement model with a new two-track system requiring physicians to accept a certain amount of risk: Merit-based Incentive Payment System (MIPS) and Alternative Payment Models (APMs).
While MACRA only impacts Medicare payments, commercial payers typically follow Medicare’s payment models, and it is likely that risk will be more prominent in the commercial setting over the next several years. This is just the beginning of the official rulemaking process, but it is already clear that physicians will have a choice in whether to participate in MIPS or meet requirements for an APM.
The Medical Association is studying the proposed rule and may provide comments particularly on those provisions of the rule of most significance to smaller practices. The timeline of the implementation of MACRA is of the utmost importance in that physicians will begin reporting Jan. 1, 2017, which will affect Medicare payments in 2019. The Association will provide more information as it becomes available.
The Impact of MACRA (Fall 2016, Alabama Medicine magazine)
MACRA: Essential Strategies in Economic Reform (Originally broadcast November 7, 2016)
- Identify strategies to implement in your personal practice that will prepare you for the transformations coming your way with MACRA legislative mandated changes.
- Describe the role of effective data capture starting in 2017 to determine the value of services and health care reimbursement under population-based payment (PBP) models being applied effective in 2019.
- Implement changes in improved data capture that aligns with MACRA essential documentation within the group practice and among organizational leaders.
MACRA 911 Articles
ABCs of MACRA (December 15, 2016)
Will MACRA Make Interoperability Better? (September 23, 2016)
Physicians Will Have More Flexibility (September 9, 2016)
What Questions Should You Be Asking Right Now? (August 12, 2016)
Could MACRA Be Delayed? (July 21, 2016)
Physicians Urge MACRA Delay (July 8, 2016)
Will MACRA Destroy the Small Physician Practice? (June 23, 2016)
MIPS vs. APM (June 10, 2016)
Getting Started (May 27, 2016)
More MACRA Links
Centers for Medicare & Medicaid Services
American Medical Association
American Academy of Family Physicians
MACRA Ready – Resources for the Medicare Access and CHIP Reauthorization Act of 2015
*On-Demand webinars require membership
American College of Cardiology
Piecing Together the MACRA Puzzle
American Congress of Obstetricians and Gynecologists
MACRA Quality Payment Program
American College of Surgeons
Quality Payment Program Resource Center