MACRA & QPP
Life before the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA)
Before MACRA was enacted, physicians and eligible clinicians were in a fee-for-service (FFS) payment system, where clinicians were paid based on volume of services, not value. As part of this FFS system, the Sustainable Growth Rate (SGR) formula was used to control the cost of Medicare payments to physicians. For example, if overall physician costs were greater than target Medicare expenditures then, physician payments were cut across the board. Each year, Congress passed temporary “doc fixes” to avert cuts.
Today: MACRA and the QPP
Authorized and funded by MACRA, the Quality Payment Program (QPP) ends the SGR formula and reforms Medicare Part B payments for more than 600,000 clinicians across the country. By taking this major step, CMS is working to improve care across the entire health care delivery system.
Two Tracks to Choose From
Eligible clinicians can choose how they want to participate in the QPP based on their practice size, specialty, location, or patient population.