Scheduled to take effect in 2019, the Medicare Access and CHIP Reauthorization Act (MACRA) changes Medicare payments from a fee-for-service to a value-based model. MACRA replaces the sustained growth formula (SGF) and replace it with a .5% annual rate increase through 2019. Physicians will be asked to shift to either the one of two Quality Payment Programs: Merit-Based Incentive Payment System (MIPS) or an Alternative Payment Model (APM).
Review MACRA basics here.
MACRA is separate from the Affordable Care Act (ACA) and well-liked in both houses of Congress, so it is likely to remain as law, whether the ACA is repealed, replaced, modified, or left as is.
A recent study in Health Affairs projects that hospitals could lose or gain billions of dollars, depending on the model. So much is uncertain at this point that even highly diverging models could diverge even further down the road.
Our advice is to prepare for MACRA by understanding the options and continuing work to improve care quality and health outcomes, which will serve healthcare organizations and their patients, regardless of which CMS payment program they choose. measures to improve quality of care and
The American College of Physicians (ACP) has developed an online tool to help physicians “understand and embrace the Medicare Access and CHIP Reauthorization Act (MACRA).”
The Quality Payment Advisor is equipped with a complex algorithm that determines which information and resources are most appropriate to a particular practice.