Medicare's MACRA & Why It Matters

MACRA is the Medicare Access & CHIP Reauthorization Act. 

It’s a game-changing law for any organization receiving Medicare physician payments. 

In 2015, MACRA replaced the Medicare sustainable growth rate (SGR) formula, which proved to be a flawed way for the government to reimburse physicians for providing care under the Affordable Care Act (ACA).  

MACRA is here, it’s moving fast, & we don’t want you to be left behind. 

A few MACRA facts you need to know:

  • MACRA rewards providers for the value of their care, not the volume. 
  • Organizations with PCMH Recognition have a significant advantage in maximizing MACRA payments. 
  • MACRA is a phased implementation between 2015 and 2025, when it will be completely phased in. The time to start is now.
  • There are two ways to be paid: 
    Alternative Payment Models (APM)
    Merit-Based Incentive Payment Systems (MIPS)
  • MACRA has the potential to help & impact practices of all sizes. 
    Practices with fewer than 15 eligible professionals will be qualified to receive a portion of $100 million from the department of Health & Human Services (HHS). 
    Priority areas include rural, underserved, low composite score practices, & health professional shortage areas.
  • Currently, there are different types of Medicare quality reporting systems. MACRA streamlines these systems into one central system for quality reporting.

Want to know about MACRA, APM & MIPS? 

Stay tuned for upcoming blogs from Clarify on APM & MIPS payment systems, how they compare, & how your organization can best prepare for MACRA. 

You can find out more about MACRA here.

Want to know more about Clarify? Check out our website or contact us. We’ll be happy to hear from you.

Sources: NCQA, HealthAffairs, AAFP, CMS.gov