MACRA & You

Medicare Access and CHIP Reauthorization Act (MACRA)

The Centers for Medicare & Medicaid Services (CMS) began implementing the sweeping payment reforms called for under the Medicare Access and CHIP Reauthorization Act (MACRA) in January 2017.

MACRA repeals the sustainable growth rate (SGR) formula and creates the Quality Payment Program (QPP) that rewards physicians and clinicians for giving better care, not just more care.

Under the QPP, clinicians can report quality metrics through two tracks:

Eligibility and Requirements

Medicare Part B clinicians who bill more than $30,000 per year and provide care for more than 100 Medicare patients annually are eligible to participate in the MIPS track.

An Advanced APM lets practices earn more for taking on risk related to their patients' outcomes. To be an advanced APM, the following requirements must be met:

  • Require participants to use certified electronic health record technology (CEHRT)
  • Provide payment for covered professional services based on quality measures comparable to those used in the quality performance category of MIPS
  • Either be a Medical Home Model expanded under CMS Innovation Center authority; or require participating APM Entities to bear more than a nominal amount of financial risk for monetary losses.

Do you need to report? Determine your QPP eligibility.

Are you ready to report? AQI's MACRA Readiness Checklist will help you prepare for MACRA quality reporting.

Advocacy

The Centers for Medicare & Medicaid Services (CMS) routinely publish Requests for Information and additional Federal Regulatory Rules that affect participants of the program. Read more about ASA's positions on important issues.

MACRA Acronyms

We've composed a helpful guide that translates acronyms and terms related to or part of MACRA. View the full list of MACRA acronyms.

More Solutions & Resources

Get started with the ASA resources below. You can also find CMS Resources here and ASA FAQs here for all things MACRA.