The Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) changed the way physicians and other clinicians are paid for Medicare Part B services. MACRA repealed the Medicare Sustainable Growth Rate (SGR) formula and replaced the Medicare reporting program (the Physician Quality Reporting System (PQRS), the Medicare Electronic Health Records (EHR) Incentive Program, and the Value-Based Payment Modifier (VM)) with a new program—the Quality Payment Program (QPP). The QPP is part of the Centers for Medicare and Medicaid Services’ efforts to shift away from the traditional fee-for-service model to a value-based payment model.
The QPP has two payment tracks for physicians and other clinicians under Medicare Part B:
Under this track, physicians may earn a performance-based payment adjustment
Under this track, physicians may earn a Medicare incentive payment
The first performance year began on January 1, 2017 and will impact payments adjustments in 2019.
Our tools and resources will help physicians ready to maximize their participation in MIPS or interested in exploring the path toward APMs to reap the maximum financial reward and patient outcomes. If you’re new to MACRA and would like to learn more about the fundamentals, PAI, CMS and AMA have substantial resources to start you on your educational journey.