A Look at MACRA: What to Expect in 2017

Area of Science:

• Health Policy
• Medical Economics
• Physician Reimbursement

Background:

• The Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) significantly alters physician payment structures for Medicare beneficiaries.
• Physicians' current payment models will transition to new systems based on performance.
• Understanding MACRA is crucial for physicians to adapt to future reimbursement changes.

Purpose of the Study:

• To summarize the key provisions of the MACRA law concerning physician payments.
• To outline the two primary pathways established by MACRA for determining future Medicare payments.
• To inform physicians about the timeline and implications of the new payment system.

Main Methods:

• Review of the Medicare Access and CHIP Reauthorization Act of 2015 legislation.
• Analysis of the payment pathways established by the act: Merit-based Incentive Payment System (MIPS) and Advanced Alternative Payment Models (APMs).
• Explanation of the performance measurement period and its impact on future reimbursement.

Main Results:

• Physician payments in 2017 will not be immediately affected by MACRA.
• Physician performance data collected in 2017 will be used to calculate payment adjustments beginning in 2019.
• MACRA introduces two distinct tracks for physician participation and payment determination.

Conclusions:

• Physicians must prepare for a performance-driven payment environment under MACRA.
• The Merit-based Incentive Payment System (MIPS) and Advanced Alternative Payment Models (APMs) represent the future of Medicare physician reimbursement.
• Proactive engagement with MACRA's framework is essential for physicians to optimize their financial outcomes.