Medicare Payment Reform

Prepare for changes happening through the Medicare Access & CHIP Reauthorization Act (MACRA).

Understanding Medicare Payment Reform (MACRA)

The proposed rule was issued on April 27, 2016 by the Centers for Medicare & Medicaid Services (CMS). AMA staff is continuing a rigorous review of the proposed rule and will provide detailed comments to CMS by the June 27 deadline.

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MACRA Stabilizes Medicare Physician Pay

Following years of advocacy by the nation's physicians standing up for their patients and their practices, Congress repealed the sustainable growth rate (SGR) formula. The Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) permanently eliminates SGR (and its annual threat of physician payment cuts) and provides positive annual payment updates lasting through 2019.

From research to education, and advocacy to practice management tools, the AMA is providing the key resources physicians need to succeed through this long-term transition.



Physician Choices

With the proposed rule, physicians can choose between 2 different pathways of payment models—alternative payment models (APMs) and the Merit-Based Incentive Payment System (MIPS):

Alternative Payment Models: MACRA supports physicians who choose to adopt new payment and delivery models approved by the Centers for Medicare & Medicaid Services. Participation in these new models is entirely voluntary. Physicians who choose to be paid under eligible APMs are exempt from participating in MIPS.

Merit-Based Incentive Payment System: MACRA also retains a modified fee-for-service model and consolidates former reporting programs (Physician Quality Reporting System, Value-Based Modifier, Meaningful Use) to provide greater flexibility.

Preparing Your Practice for Value-Based Care

View our AMA STEPS Forward™: Practice Transformation Series learning module.

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Medicare Payment Reform News

Draft regulations outline next phase of Medicare 4/27/2016

A 962-page proposed rule released Wednesday by the Centers for Medicare & Medicaid Services (CMS) details the draft regulations the agency is considering for implementation of last year's groundbreaking Medicare reform law.

Historic Medicare payment policy changes an opportunity for success 4/27/2016

An AMA Viewpoints post by AMA President Steven J. Stack, MD
Proposed rules  issued Wednesday by the Centers for Medicare & Medicaid Services (CMS) represent the most sweeping change in physician payment policy in the last 25 years.

Physicians tell House panel the keys to MACRA implementation 4/19/2016

Physician leaders Tuesday testified before an influential congressional committee, calling attention to the promise of the landmark Medicare reform law, and the necessary steps to ensure implementation is optimal for physicians and patients.

Read more news on AMA Wire® >

Physician Payment and Delivery Models

Read more about tools and resources for assessing and choosing payment models.

View Tools and Resources