Implementing MACRA

This Viewpoint discusses the Medicare Access and CHIP Reauthorization Act and the key features of the law and the opportunities it presents to shape the future of payment and medical practice.

On April 27, the Centers for Medicare & Medicaid Services (CMS) released the highly anticipated 962-page proposed rule¹ for implementing the Medicare Access and CHIP Reauthorization Act (MACRA). MACRA will overhaul Medicare’s physician payment system starting in 2019, placing most physicians in the Merit-Based Incentive Payment System (MIPS), a pay-for-performance system that adjusts payments based on measures derived from prior care. Physicians can be exempt from MIPS and receive bonus payments by demonstrating sufficient participation in advanced alternative payment models (APMs), which are intended to support greater flexibility in care delivery alongside greater accountability for efficiency and care improvement.