[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"detail-sidebar-cat-1-en-105":3,"doc-seo-573317-105":53,"doc-detail-573317-en":120},{"code":4,"msg":5,"data":6},0,"success",[7,14,19,24,29,34,39,44,49],{"id":8,"doc_module":9,"doc_module_name":10,"category_name":11,"show_sort_weight":12,"slug":13},11,1,"Template","Presentations",90,"presentations",{"id":15,"doc_module":9,"doc_module_name":10,"category_name":16,"show_sort_weight":17,"slug":18},12,"Resumes",80,"resumes",{"id":20,"doc_module":9,"doc_module_name":10,"category_name":21,"show_sort_weight":22,"slug":23},14,"Invoices",70,"invoices",{"id":25,"doc_module":9,"doc_module_name":10,"category_name":26,"show_sort_weight":27,"slug":28},15,"Posters",60,"posters",{"id":30,"doc_module":9,"doc_module_name":10,"category_name":31,"show_sort_weight":32,"slug":33},16,"Social Media",50,"social-media",{"id":35,"doc_module":9,"doc_module_name":10,"category_name":36,"show_sort_weight":37,"slug":38},17,"Forms",40,"forms",{"id":40,"doc_module":9,"doc_module_name":10,"category_name":41,"show_sort_weight":42,"slug":43},18,"Letters",30,"letters",{"id":45,"doc_module":9,"doc_module_name":10,"category_name":46,"show_sort_weight":47,"slug":48},21,"Paper Templates",5,"papers-templates",{"id":50,"doc_module":9,"doc_module_name":10,"category_name":51,"show_sort_weight":4,"slug":52},158,"General","general-158",{"code":4,"msg":54,"data":55},"ok",{"site_id":56,"language":57,"slug":58,"title":59,"keywords":60,"description":61,"schema_data":62,"social_meta":113,"head_meta":115,"extra_data":117,"updated_unix":119},105,"en","medicare-access-and-chip-reauthorization-act-macra-educational-briefing-for-providers","Medicare Access and CHIP Reauthorization Act (MACRA) - Educational briefing for providers","","Educational briefing for providers explaining the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) and its Quality Payment Program. Describes how MACRA moves physician reimbursement from fee-for-service toward performance-based incentives, including the Merit-Based Incentive Payment System (MIPS) and Alternative Payment Models (APMs). Outlines qualification and exclusions, how MIPS scores drive bonuses or penalties, and how APM participants can receive rewards tied to risk models, with the first performance year set for 2017.",{"@graph":63,"@context":112},[64,80,95],{"@type":65,"itemListElement":66},"BreadcrumbList",[67,71,74,77],{"item":68,"name":69,"@type":70,"position":9},"https://docshare.wps.com","Home","ListItem",{"item":72,"name":10,"@type":70,"position":73},"https://docshare.wps.com/template/",2,{"item":75,"name":41,"@type":70,"position":76},"https://docshare.wps.com/template/letters/",3,{"item":78,"name":59,"@type":70,"position":79},"https://docshare.wps.com/template/medicare-access-and-chip-reauthorization-act-macra-educational-briefing-for-providers/573317/",4,{"url":78,"name":59,"@type":81,"author":82,"headline":59,"publisher":85,"fileFormat":88,"inLanguage":57,"description":61,"dateModified":89,"datePublished":89,"encodingFormat":88,"isAccessibleForFree":90,"interactionStatistic":91},"DigitalDocument",{"name":83,"@type":84},"Rainbow Cat","Person",{"url":68,"name":86,"@type":87},"DocShare","Organization","application/pdf","2026-10-14",true,{"@type":92,"interactionType":93,"userInteractionCount":4},"InteractionCounter",{"@type":94},"ViewAction",{"@type":96,"mainEntity":97},"FAQPage",[98,104,108],{"name":99,"@type":100,"acceptedAnswer":101},"What is MACRA and what payment program does it create?","Question",{"text":102,"@type":103},"MACRA is the Medicare Access and CHIP Reauthorization Act of 2015. It established the Quality Payment Program, a new way to pay doctors who treat Medicare patients.","Answer",{"name":105,"@type":100,"acceptedAnswer":106},"What are the two payment tracks under MACRA?",{"text":107,"@type":103},"MACRA affects payment through the Medicare Physician Fee Schedule and requires eligible clinicians to participate in either MIPS (Merit-Based Incentive Payment System) or APMs (Alternative Payment Models).",{"name":109,"@type":100,"acceptedAnswer":110},"How do MIPS and APMs determine financial adjustments?",{"text":111,"@type":103},"In MIPS, providers receive a score (0-100) across four categories and earn bonuses or penalties compared with a CMS performance threshold. In APMs, participants receive rewards such as a 5% bonus for 2019-2024, with baseline adjustments and penalties/rewards tied to their risk model.","https://schema.org",{"og:url":78,"og:type":114,"og:title":59,"og:site_name":86,"og:description":61},"article",{"robots":116,"canonical":78},"index,follow",{"doc_id":118,"site_id":56},573317,1791937089,{"code":4,"msg":5,"data":121},{"doc_id":118,"user_id":122,"nickname":83,"user_avatar":123,"doc_module":9,"category_id":40,"category_name":41,"doc_title":59,"doc_description":61,"doc_content":124,"file_id":125,"file_url":126,"file_type":127,"file_size":128,"view_count":4,"is_deleted":4,"is_public":9,"is_downloadable":9,"audit_status":9,"page_count":73,"language":129,"language_code":57,"site_id":56,"html_lang":57,"table_of_contents":130,"faqs":131,"seo_title":132,"seo_description":61,"update_tm":119,"read_time":9},962090769181,"https://ap-avatar.wpscdn.com/davatar_6f874abed73319feea01a86fa6f0fab8","Published by Physician Practice Roundtable  \nMedicare Access and CHIP Reauthorization Act  \nEducational briefing for providers  \nWhat is MACRA?  \nMACRA—the Medicare Access and CHIP Reauthorization Act of 2015, or “Doc Fix Bill”—established a new way to pay doctors who treat Medicare patients, called the Quality Payment Program. It is the most significant heath care bill since the Affordable Care Act and garnered strong bipartisan support. The law replaced the Sustainable Growth Rate formula that aligned Medicare Part B spending with gross domestic product (GDP) growth. It seeks to transition physician reimbursement from pure fee-for-service to pay-for-performance incentives on a diverse set of metrics, as well as encourage participation in risk-based payment models. The first performance year for the Quality Payment Program of MACRA was 2017. Payment is based on performance from two years prior.  \nHow does MACRA work?  \nMACRA affects physician payment under the Medicare Physician Fee Schedule. It established baseline reimbursement updates of near-zero growth and requires eligible clinicians 1 to participate in one of two payment tracks: Merit-Based Incentive Payment System (MIPS) or Alternative Payment Models (APMs) .  \nMIPS track  \nAPM track  \nMerit-Based Incentive Payment System (MIPS)  \nMIPS rolls existing quality programs (Physician Quality Reporting System, Value-Based Payment Modifier, and Meaningful Use) into one budget-neutral program. Providers are scored on quality, cost, improvement activities (IA), and promoting interoperability (PI; or EMR2 use) and assigned payment adjustment accordingly.  \n Who qualifies?  \n• Nearly all clinicians that do not meet the criteria to qualify for the APM track  \n Who is excluded?  \n• Medicare Part A, providers in first year billing Medicare  \n• Clinicians, groups that fall under low-volume threshold  \nBonuses and penalties in MIPS  \nIn MIPS, providers are assigned a score of 0-100 based on their performance in four categories. That score is compared to a CMS-determined performance threshold (PT) . Those above the PT receive a bonus, those below a penalty. A scaling factor up to 3x may be applied to bonuses to ensure payout pool equals the penalty pool. High-performers may be eligible for up to 10% in additional incentives. Beginning in payment year 2026, MIPS participants will see a lower baseline annual update (0 .25%) compared to APM participants.  \nUpdated November 2018.  \n1) Eligible clinicians include physicians, physician assistants, nurse practitioners, clinical nurse specialists, certified registered nurse anesthetists, and groups that include such clinicians.  \n2) Electronic medical record.  \n3) The low volume threshold is $90,000 or less in Medicare charges OR 200 or fewer Medicare patients or 200 or fewer Medicare covered professional services for performance year 2019.  \nSource: CY 2018 Quality Payment Program Final Rule, CMS; H. R.1314 -Bipartisan Budget Act of 2015; Advisory Board research and analysis.  \n© 2018 Advisory Board • All rights reserved [1](1 advisory.com)[ advisory.com](1 advisory.com)  \nMedicare Access and CHIP Reauthorization Act  \nEducational briefing for providers (continued)  \nAlternative Payment Models (APM)  \nThe APM track exempts providers from the MIPS track. To qualify, participants must have a significant share of their Medicare revenue and/or patients in contracts that include two-sided payment risk.  \nTo qualify, clinicians must meet two criteria:  \nParticipate in an advanced APM as defined by CMS  \nAND  \nSample qualifying models for 20181 :  \n• MSSP2 Track 1+, 2,3, Next Gen3 ACOs  \n• Bundled Payments for Care Improvement Advanced Model (BPCI Advanced)  \n• Comprehensive Primary Care Plus (CPC+)  \n• Oncology Care Model (OCM)– Two-Sided  \nRewards in APM track  \nFrom payment years 2019-2024 , participants will receive a 5% bonus. In payment year 2026 , APM participants will receive a higher baseline payment adjustment (0 .75%) compared to those in","cbCaipQ5NzQE1CqA","https://ap.wps.com/l/cbCaipQ5NzQE1CqA","pdf",132864,"English","# What is MACRA?\n## How does MACRA work?\n# MIPS track\n## Who qualifies?\n## Who is excluded?\n## Bonuses and penalties in MIPS\n# APM track\n## Rewards in APM track\n# Why is MACRA a key issue for medical groups?","[{\"question\":\"What is MACRA and what payment program does it create?\",\"answer\":\"MACRA is the Medicare Access and CHIP Reauthorization Act of 2015. It established the Quality Payment Program, a new way to pay doctors who treat Medicare patients.\"},{\"question\":\"What are the two payment tracks under MACRA?\",\"answer\":\"MACRA affects payment through the Medicare Physician Fee Schedule and requires eligible clinicians to participate in either MIPS (Merit-Based Incentive Payment System) or APMs (Alternative Payment Models).\"},{\"question\":\"How do MIPS and APMs determine financial adjustments?\",\"answer\":\"In MIPS, providers receive a score (0-100) across four categories and earn bonuses or penalties compared with a CMS performance threshold. In APMs, participants receive rewards such as a 5% bonus for 2019-2024, with baseline adjustments and penalties/rewards tied to their risk model.\"}]","Medicare Access and CHIP Reauthorization Act (MACRA) - Educational briefing for providers | PDF"]