Medicare Gets Serious About Value-based Payments: How MACRA Will Change Care Delivery
New payment system incentivizes a team approach to improving chronic disease outcomes
For those who view the Medicare Access and CHIP Reauthorization Act (MACRA) as an administrative and reporting distraction, it’s time to take a second look. It is the most profound change in the physician payment model since 1965, the year Medicare was enacted. The program offers physicians a variety of choices, but all those choices are designed to change care delivery by moving reimbursements away from traditional fee-for-service reimbursement and toward pay for performance. Most physicians with an active Medicare patient roster will fall under the Merit-Based Incentive Payment
System (MIPS). While MIPS is a fee-for-service arrangement, beginning in 2019 the amount of payments will be based on performance reported in 2017.
MACRA is intended to use the payment system to fundamentally change the way care is delivered, especially for patients with chronic diseases or who need complex medical management.
In this paper, we take a look at what MACRA requires, how care will be affected and how physicians, health systems and health plans should respond.