MACRA (Medicare Access and CHIP Reauthorization Act of 2015) is bipartisan federal legislation signed into law on April 16, 2015. MACRA repeals the SGR Formula that determined Medicare Part B reimbursement rates for physicians and replaces it with new ways of paying for care for many physicians.
Under MACRA, participating providers will have an increasing percentage of Medicare payments based on the quality and effectiveness of the care they provide (value focused) rather than the volume of patients as in traditional fee-for-service. High value care (termed as value-based care) will be defined by measures of quality and efficiency. Providers will earn more or less depending on their performance against those measures.
MACRA’s Quality Payment Program (QPP) establishes two payment tracks:
- Advanced Alternative Payment Models (Advanced APMs)
- Merit-Based Incentive Payment System (MIPS)