Medicare Access & CHIP Reauthorization Act (MACRA)

What is the Merit-based Incentive Payment System (MIPS) & Alternative Payment Models (APMs)?

In April 2015, Congress passed MACRA, significantly changing the way in which physicians are paid. The law repeals the sustainable growth rate (SGR), the statutory formula that did not perform as a control on the growth in aggregate Medicare expenditures for physician services as was intended by Congress, replacing it with several years of predictable updates, followed by several years of no updates. Starting in 2019, physician payment will be driven by either transitioning to alternative payment models (APM) or participating in the Merit-based Incentive Payment System (MIPS), a consolidation of the existing quality programs (PQRS, VM, and Meaningful Use). The timeline provides an overview on payment adjustments by year depending on which track your organization pursues. Additional resources are available below the timeline.

*QAPMS: qualifying alternative payment models based on Medicare payment/patient threshold requirements and excluded from MIPS

*MIPS: Merit-based Incentive Payment System, a consolidated pay-for-performance program, $500M annual pool is allocated for exceptional performers for CY 2019-2023

Webinars and Slides

• The Medicare Shared Savings Program Pathways to Success ACO Final Rule Recording and Slides  (January 28,2019)

• The AAMC and Vizient (FPSC) Quality Payment Program ( MACRA) Proposed Rule CY 2019 Recording and Slides  (December 6, 2018)

• The AAMC and Vizient (FPSC) Quality Payment Program ( MACRA) Proposed Rule CY 2019 Recording and Slides  (August 16, 2018)

• Webinar Recording on Alternative Payment Models under MACRA and Slides (November 30, 2016)

• Webinar Recording on Merit-based Incentive Payment System (MIPS) and Slides (November 29, 2016)

• APM Proposed Rule Webinar Recording and Slides  (June 2, 2016)

• MIPS Proposed Rule Webinar Recording and Slides  (June 1, 2016)

• AAMC Webinar on the MACRA Request for Information (RFI)  (October 21, 2015)

• Recording of "Passage to MACRA" Webinar and Slides  (April 17, 2015)
   

MACRA Comment Letters

• AAMC Comment Letter on the CY 2018 Updates Quality Payment Program Proposed Rule 

• AAMC Comment Letter on the 2016 MIPs, APMs Criteria for Physician-Focused Payment Models (MACRA)Proposed Rule 

Additional MACRA Resources

• Frequently Asked Questions

• One Pager 

• Checklist to Prepare for MACRA Transition 

• Group Reporting Requirements Under MIPS
   

For any additional questions or information, please email teachingphysicians@aamc.org.