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Five Fast Facts

Posted May 25, 2017

Despite the law taking effect on January 1, many clinicians and physician office managers still don’t know all they need to about MACRA – the Medicare Access and CHIP Reauthorization Act. Here are five fast facts anyone working in health care needs to know about MACRA:

  1. MACRA, the Medicare Access and CHIP Reauthorization Act, is federal legislation that was signed into law in 2015. It establishes new ways to pay physicians for caring for Medicare beneficiaries, shifting away from fee-for-service payments based on volume and toward payments based on quality and value.
  2. MACRA created the Quality Payment Program to give providers two paths for reimbursement by Medicare Part B. They can join an Advanced Alternative Payment Model or be scored under MIPS, the Merit-Based Incentive Payment System.
  3. The MACRA law and the initial performance period under MIPS went into effect on January 1, 2017. However, provider reimbursement rates will not change until 2019. CMS recentlysent letters to 806,879 clinicians saying that they will not be evaluated under MIPS in 2017 because they had less than $30,000 in Medicare charges or fewer than 100 unique Medicare patients per year.
  4. HHS Secretary Tom Price and CMS Administrator Seema Verma have been publicly critical of the law, but have proceeded with implementation. MACRA was passed with bipartisan support and is budget neutral.
  5. CMS has funded Practice Transformation Networks across the country to provide eligible practices with resources to help them be successful under MIPS and move on to an Advanced Alternative Payment Model. New Jersey practices can sign up to take advantage of this resource with theGarden Practice Transformation Network. GPTN members and Quality Institute members are invited to join the upcoming Innovation Showcase on June 22 at the NJIT Campus Center to take part in a discussion around the use of technology in the shift to more value-based care. Register now.

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