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MACRA and the Quality Payment Program

 

Medicare’s Quality Payment Program (QPP)

The Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) was signed into law on April 16, 2015. The law provides predictable Medicare payment updates for physicians and other clinicians and intends to reward high-value, low-cost care through the Quality Payment Program (QPP).

Under this program, eligible clinicians participate in one of two payment tracks to avoid penalties and earn potential increases in Medicare payments. Physicians, or their practices, can decide annually the program in which they will be participating:

MACRA Physician


MIPS

Merit-Based Incentive Payment System

Under the Merit-Based Incentive Payment System (MIPS), eligible clinicians continue to be paid on a fee-for-service basis and report cost and quality data. Following each performance year, clinicians are evaluated on their performance relative to other clinicians in the country and receive a positive, neutral, or negative payment adjustment to their Medicare Part B payments in a future payment year.  Learn more

APMs

Alternative Payment Models

Alternatively, clinicians can choose to participate in one or more of the available Alternative Payment Model (APMs). APMs vary in design, but all aim to restructure payments in a way that financially incentivize low-cost, high-value care. In addition to any model-specific payments they receive, clinicians who significantly participate in models that meet certain requirements for advanced technology, quality, and financial risk capabilities are excluded from participating in MIPS and can earn a 5% Medicare bonus. Learn more


Advocacy Efforts from ACP

Learn about ACP’s latest advocacy efforts to reform and improve the Quality Payment Program. Learn more


Have more questions?

Email reg-affairs@acponline.org

Visit the official QPP website

Join ACP's MACRA Member Forum