PAYMENT MODEL TOOLKIT FOR 2016 & BEYOND
 Understanding What is Right for Your Practice
Frequently Asked Questions


 

Medicare Access and CHIP Reauthorization Act of 2015 (MACRA)

With the passage of the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA), Medicare will change from a volume-based system to a value-based system.  Key features of this law include:

  • Repeal of the flawed SGR rate, eliminating threat of sudden payment cuts

  • Provides for automatic increases in Medicare reimbursements if you are in an Advanced Alternative Payment Model (A-APM)

  • Creates a new Merit-Based Incentive Payment System (MIPS) which consolidates several existing Medicare incentive programs (penalties apply if goals not met)

  • Provides incentives for physicians to participate in A-APM's such as Accountable Care Organizations (ACO) and Comprehensive Primary Care Plus (CPC+)


 

TIMELINE OF MACRA





OVERVIEW OF MACRA & MIPS
Learn about the MACRA legislation and timeline.
If you are not in an A-APM, the default is MIPS.




POPULATION
HEALTH MANAGEMENT

Many federal and state incentive programs require physicians to collect and analyze clinical data to assist in population health management (PHM).   Many of the principles and processes of Patient Centered Medical Homes are focused around PHM.  Therefore, if your practice is already a certified PCMH, then you are well on the road to success in the new MIPS program.  Learn more how to gather this data and leverage it to help improve your patients’ health and outcomes.