Medicare Access and CHIP Reauthorization Act (MACRA)

On April 14, 2015, President Obama signed the Medicare Access and CHIP Reauthorization Act (MACRA) into law –definitively repealing the troubled Sustainable Growth Rate (SGR) formula. AAFP and CAFPfought hard to ensure MACRA’s passage; now we will ensure that family physicians understand the new law and have the resources to respond to future changes in Medicare payment. Had Congress failed to pass MACRA, physicians would have endured a 21 percent cut in Medicare payment, threatening access to care for some of our most vulnerable populations and leaving physicians with unpredictable payment.  Instead, we can finally say good-bye to the SGR. But there is more to this law: MACRA accelerates payment reform. With the Medicare program leading the way, we increasingly will see health care services paid based on value, not volume.

What Is Included in MACRA

MACRA finally put the flawed logic of tying payment to volume to rest. Among a number of provisions,MACRA definitively repeals SGR and provides for a much more predictable, patient-oriented payment scheme. 

Timeline of Fee Updates

Now-June 2015: Eligible professionals who participate in Medicare will continue to enjoy the pre-April 1 payment rates, averting a 21 percent pay cut.

June 2015-December 2015: Physician payments will increase by 0.5 percent.

January 2016-December 2019: Physician payments will continue to increase by 0.5 percent each year.

January 2020-December 2025: No further payment updates will be scheduled; rates will be equivalent to 2019 levels. Physicians will have the opportunity, however, to choose from two payment tracks with additional payment adjustments.