MACRA
MACRA, the Medicare Access and CHIP Re-Authorization Act, is sweeping legislation enacted in April 2015. MACRA repeals the Sustainable Growth Rate (SGR) formula originally enacted in 1997. To control the growth of Medicare costs, SGR is replaced by value-based reimbursement programs. These value-based reimbursement programs include Alternative Payment Models (APMs) such as Accountable Care Organizations (ACOs), Patient Centered Medical Homes (PCMHs) and others. For physicians and other providers who do not participate in an APM, the Merit-Based Incentive Payment System (MIPS) will reward providers who deliver high-value care while penalizing those who provide low-value care.
by Gary Pritts | May 20, 2016 | CMS Quality Payment Programs, General News
The CMS “incentive” programs over the past several years — Meaningful Use, PQRS, ePrescribing, and the Value-modifier — have been used both the “carrot” and “stick” approach. CMS provides both cash bonuses and penalties. The... Read More
by Gary Pritts | May 19, 2016 | CMS Quality Payment Programs, General News
As we mentioned in the last post, both MIPS and Advanced APMs are a part of the Quality Payment Programs. These programs replace the reimbursement structure in place for practices in 2017. So what is the difference between MIPS and Advanced APMs? CMS estimates that... Read More
by Gary Pritts | May 25, 2015 | CMS Quality Payment Programs, General News
On April 16, 2015 the President signed legislation to repeal the Medicare sustainable growth-rate (SGR) formula for paying doctors. This repeal, of course, was welcomed by the physician community tired of the annual fight to restore reimbursement. Also included in... Read More
