The AAFP created a five-page executive summary to help explain the most relevant parts of the Medicare Access and CHIP Reauthorization Act to family physicians.
Some of the highlights of the summary include these need-to-know informational nuggets:
- CMS' inclusion of a "pick-your-pace" policy gives physicians choices as to how fast they proceed and includes an optional 90-day reporting period in 2017.
- If a practice participates in the Merit-based Incentive Payment System (MIPS) for any period of time in 2017, no penalty will be assessed in 2019.
- All physicians who participate in Medicare Part B will receive a positive 0.5 percent payment update for services provided in 2017.
- Physicians should plan to participate in 2017 -- even if only by reporting on one measure or improvement activity; failure to do so will result in a 4 percent negative adjustment in 2019 Medicare Part B payments.
Other resources available:
Review AAFP's side-by-side comparison.
Understand your pathway. PDF is available to members only (You'll need your member id and password)
Not familiar with all the acronyms yet? See AAFP's list of MACRAnyms.
MACRA Recap and What's to Come
The US Senate passed MACRA of 2015 HR 2 by a vote of 92-8 in April 2015. The legislation was previously passed by the House 392-37 in March. President Obama signed the law into action which followed a White House Ceremony celebrating the SGR repeal later that month.
The MACRA repealed the flawed Medicare sustainable growth rate (SGR) formula that calculates pavement rates to physicians. The legislation established an alternative set of annual payment updates to replace the SGR:
- Repeals the SGR
- Establishes a defined payment system that transitions away from fee-for-service
- Preserves fee-for-service, but under strict quality performance standards
- Provides financial assistance to small/solo practices to facilitate transformation
- Streamlines current quality and performance programs into a single program
- Sets a date certain for electronic medical record (EMR) interoperability
- Establishes expectations regarding the use of quality and performance data in medical liability cases
Other significant Provisions include extending funding for:
- Teaching Health Center Graduate Medical Education (GME)
- Community Health Centers
- National Health Services Corps
What does this mean for you, the member?
- The annual update for July 1, 2015 through 2019 is set at 0.5%
- For years 2020-2025 the annual update is set at 0.0%
- For years 2026 forward the annual update is set at 0.75% for qualifying alternative payment models (APM) participants and 0.25% for all other physicians
- An In-Depth Summary of Public Law 114-10: Medicare Access & Children's Health Insurance Program Reauthorization Act
- MACRA FAQ
- MACRA Acronymns
- MACRA Payment: APM vs MIPS
- MACRA Readiness: Prepare for MIPS