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Preparing for MACRA: Top 3 priorities for 2016

Medicare payments for physician services are about to change drastically. The Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) was passed to replace the flawed Medicare Sustainable Growth Rate in April of 2015 with overwhelming bipartisan support, but very little attention or fanfare. However, with the release of the long-awaited proposed rule on April 27, 2016, healthcare organizations are beginning to realize the profound implications of this sweeping legislation.

The Department of Health and Human Services has set a goal of tying over half (50 percent) of traditional, or fee-for-service, Medicare payments to quality or value through alternative payment models (APMs), such as Accountable Care Organizations (ACO’s) and bundled payments, by the end of 2018. This is the first time in the history of the Medicare program that HHS has set explicit goals for alternative payment models and value-based payments, and the MACRA legislation will serve as the mechanism to achieve this aggressive goal. MACRA is required to be budget neutral, but payments to providers will be increased and decreased based on their quality and value. And the resulting scores will be publicly reported, affecting providers’ reputation with patients and other payers.

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Alternative Payment Models, APMs, CCM, Chronic Care Management Program, Infina Connect, MARCA, Medicare Access and CHIP Reauthorization Act of 2015, Merit-based Incentive payment system, MIPS, “Adopting Accountable Care: An Implementation Guide for Physician Practices”


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