MACRA is a transformative law that builds a new, fast-speed highway to take the healthcare system away from the fee-for-service system and toward new risk-bearing, coordinated care models.
“Once the program is up and running, physicians can pick one of two routes that will determine how they will be paid: Merit-Based Incentive Payment System (MIPS) or an advanced alternative payment model (APM).”
1. This rule applies only to physician practices and to Medicare
For now, only physician offices – not hospitals – are governed by MACRA rules. In addition, this program only applies to payments physicians receive from Medicare. Medicaid is not included.
2. Performance data from 2017 will determine payment in 2019
With Medicare payments or penalties under MACRA being handed out starting in 2019, that can feel like a long time away. But it’s closer than many physicians may realize.
Keeping to tradition, CMS plans to use data collected in 2017 to determine payment adjustments for 2019.
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