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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.

Episode-based cost measures

We’re sharing the information below as a part of the 8 episode-based cost measures field testing taking place from October 16, 2017 to November 20, 2017 at 12 pm ET (extended from the original deadline of November 15, 2017).  *Updated*

You can give us your feedback on these materials.

  • The fact sheet gives you basic information about episode-based cost measures, the field testing process, and how clinicians and groups can access their own practices' reports.
  • The FAQs give you more information in a question and answer format.
  • The mock report is a sample Episode-Based Cost Measure Field Test Report you can use for review.
  • This zip file has all the supporting documentation for the episode-based cost measures under development, including an index that will tell you the purpose of each document.
  • Read the National Summary Data Report.

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