The Medicare Access and CHIP Reauthorization Act (MACRA) of 2015: What's New?

Area of Science:

• Healthcare policy
• Medical economics
• Orthopaedic practice management

Background:

• The Medicare Access and CHIP Reauthorization Act (MACRA) introduced significant changes to healthcare reimbursement.
• The Centers for Medicare and Medicaid Services (CMS) issued a Final Rule in November 2016 to implement MACRA.
• Understanding these policy shifts is crucial for healthcare providers.

Purpose of the Study:

• To summarize the key provisions of the CMS Final Rule on MACRA.
• To inform the orthopaedic community about upcoming changes in healthcare policy.
• To outline the implications of the Quality Payment Program (QPP) for orthopaedic practices.

Main Methods:

• Review of the CMS Final Rule on MACRA.
• Analysis of the components of the Quality Payment Program (QPP).
• Identification of policy alterations affecting healthcare practices nationwide.

Main Results:

• The Final Rule establishes the Merit-based Incentive Payment System (MIPS) and Alternative Payment Models (APMs).
• These components collectively form the Quality Payment Program (QPP).
• The QPP aims to shift Medicare payments towards value-based care.

Conclusions:

• The MACRA Final Rule represents a significant policy change for the healthcare industry.
• Orthopaedic practices must adapt to the requirements of the Quality Payment Program (QPP).
• Proactive engagement with these policy changes is essential for practice sustainability and success.