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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.

MACRA 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

CY 2016 Webinars and Slides

Previous Webinars and Slides

Additional MACRA Resources

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

On Patient Care


Testimony and Correspondence