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MACRA: MIPS & APMs


MACRA

What's MACRA?

The Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) is a bipartisan legislation signed into law on April 16, 2015.

MACRA created the Quality Payment Program that:

  • Repeals the Sustainable Growth Rate formula
  • Changes the way that Medicare rewards clinicians for value over volume
  • Streamlines multiple quality programs under the new Merit Based Incentive Payments System (MIPS)
  • Gives bonus payments for participation in eligible alternative payment models (APMs)

MACRA also required us to remove Social Security Numbers (SSNs) from all Medicare cards by April 2019.

Quality Payment Program

You can learn more about the Quality Payment Program at qpp.cms.gov and on our CMS.gov pages. On 11/1/17, we moved the Quality Payment Program content you’re used to finding here to our new CMS.gov Quality Payment Program pages.

What's new?

Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) Funding Opportunity: Measure Development for the Quality Payment Program

On March 2, 2018 we published the “Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) Funding Opportunity: Measure Development for the Quality Payment Program” on Grants.gov. This Notice of Funding Opportunity gives cooperative agreements funding assistance to entities so they can:

  • Develop
  • Improve
  • Update or
  • Expand

Quality measures to use in the Quality Payment Program. We know there are benefits when external stakeholders develop measures because they know best about clinician and patient perspectives and needs.

Update: The new application due date for the “Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) Funding Opportunity: Measure Development for the Quality Payment Program” is May 30, 2018 at 3:00 p.m. ET.  On April 12, 2018 we updated the application due date on Grants.gov and extended the due date because there were questions about the application process. On May 3, 2018 we updated the eligibility criteria in order provide further clarification for those that are interested in applying.

Who should apply for the Funding Opportunity?

We invite external stakeholders who develop quality measures to apply, including:

  • Clinical specialty societies
  • Clinical professional organizations
  • Patient advocacy organizations
  • Educational institutions
  • Independent research organizations
  • Health systems
  • Others entities engaged in quality measure development

These stakeholders give the medical specialty and patient perspectives we need to lead or support the measure development priorities of the CMS Quality Measure Development Plan.

What are the cooperative agreement priorities?

The CMS Quality Measure Development Plan was developed and updated to provide a strategy to build on the Quality Payment Program measure portfolio according to section 1848(s)(1) of the Social Security Act, as added by section 102 of the MACRA. The quality measurement goals and priorities we’re sharing go with the Measure Development Plan’s goals and priorities.

Our measures work is guided by the Meaningful Measurement framework which finds the highest priorities for quality measurement and improvement. The Meaningful Measure Areas connect the goals we’re working on and the individual measures and initiatives that show how we’re achieving high quality outcomes for people with Medicare, Medicaid, and CHIP. These quality topics show the core issues most important to high quality care and better patient outcomes.

Through these cooperative agreements, we want to give the support that’s needed to help external stakeholders expand the Quality Payment Program quality measure portfolio, focusing on essential topics, such as clinician and patient perspectives and minimizing reporting burden for clinicians.

Focusing on patient perspectives makes sure measures are about what’s important to patients and improve patient outcomes. Cooperative agreements will prioritize developing:

  • Outcome measures
    • Patient reported outcome
    • Functional status
  • Patient experience measures
  • Care coordination measures
  • Measures of appropriate use of services, including measures of overuse

Where can I learn more & apply?

You can find the ‘Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) Funding Opportunity: Measure Development for the Quality Payment Program’ by searching the title or Catalog of Federal Domestic Assistance (CFDA) number 93.986 on Grants.gov.

Learn about grants and cooperative agreements, as well as the application process at Grants.gov.

Take a look at our pre-application conference call materials to learn about the Notice of Funding Opportunity and application process:

See our frequently asked questions about program requirements, eligibility, timeline, and application review and selection process for more clarification. This document will be updated periodically.

New Medicare cards

MACRA requires us to remove Social Security Numbers (SSNs) from all Medicare cards. When we replace the SSN on all Medicare cards, we can better protect:

  • Private health care and financial information
  • Federal health care benefit and service payments
.