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Understanding Medicare Payment Reform (MACRA)

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CMS Finalizes Historic Medicare Reform Law

A final rule released on Oct. 14, 2016 by the Centers for Medicare and Medicaid Services (CMS) details the final regulations for implementation of the Medicare Access and CHIP Reauthorization Act (MACRA), the historic Medicare reform law that repealed the Sustainable Growth Rate (SGR) formula and created the Quality Payment Program (QPP). Read the AMA summary or view the key changes in the QPP final rule.

CMS responded to many of the concerns expressed by physicians about the proposed rule issued last spring. That said, much work remains to be done to simplify and improve the QPP. The AMA remains heavily engaged with CMS on all aspects of the program. Read more about the details on AMA Wire®. Summaries, fact sheets and other CMS resources are available on the agency's website.

The AMA Payment Model Evaluator

The AMA Payment Model Evaluator provides you with educational resources, a brief assessment to discover where your practice stands under MACRA.

Inside Medicare's New Payment System

Listen to industry experts and physician leaders discuss topics such as new payment models and quality reporting in this interview series from ReachMD™ and the AMA. Recent interviews include the following podcasts:

Two Payment Pathways for Physicians

Consistent with the law, the final rule creates 2 different payment pathways for physicians—alternative payment models (APMs) and the Merit-based Incentive Payment System (MIPS).

Preparing Your Practice for Value-based Care

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

QPP Resources

QPP Resources for Small Practices 

CMS awarded $20 million to 11 organizations for the 1st year of a 5-year program to provide QPP training for clinicians in individual or small group practices of 15 or fewer. The AMA supported this technical assistance when MACRA was being drafted and urged the administration to award these funds. CMS will award a total of $100 million over the 5 years.

Awardees will assist practices, at no charge, with the following types of activities:

  • Conveying expectations and timelines for the Merit-based Incentive Payment System (MIPS)
  • Evaluating practice readiness
  • Assessing and optimizing health information technology
  • Supporting change management and strategic planning
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