Policy and Clinician Payment: Do You Know These Changes Affecting Your Pocketbook?

Gordon H. Sun, MD, MS


August 10, 2018

What Is MACRA?

The Medicare Access and CHIP Reauthorization Act of 2015, also known as MACRA, is perhaps most well known for repealing the Sustainable Growth Rate formula. MACRA also extended funding for the Children's Health Insurance Program (CHIP) and revamped the Medicare reimbursement system by establishing the Quality Payment Program, reflecting a shift toward value rather than volume.[11] The two new ways to get paid under the Quality Payment Program are:

  1. The Merit-based Incentive Payment System (MIPS), which consolidates three older quality-based programs into a single framework; and

  2. Alternative payment models (APMs), which incentivize high-quality, cost-efficient care based on specific conditions, care episodes, or patient population.

The Merit-based Incentive Payment System


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