Medicare is Making Fundamental Changes in the Way Doctors Get Paid That Will Affect Your Health Care

CA Medicare Announcement, Resources

In 2015, President Barack Obama signed the Medicare Access and CHIP Reauthorization Act, or “MACRA.”

MACRA represents a major change in how doctors will be paid for treating Medicare payments. The ultimate goal of MACRA is to shift from the current fee-for-service model to ‘performance’ and ‘composite scores’ based on four categories: quality, resource use, meaningful use of electronic medical records, and clinical practice improvement activities.

MACRA is a win win for patients, because they will receive better and more efficient care under the four categories. MACRA’s end goal is simple. If physicians comply with the new requirements, they will be awarded and if they don’t, they will be penalized. However, some doctors are not happy with these new changes, since it will result in having to change some of their old school methodology and comply with quality and efficiency standards as well as the use of electronic records.

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MACRA will change the way that Medicare rewards clinicians for for value over volume and will change our current health care system in the United States and focus on 3 goals.

According to these 3 goals are:

  1. Incentives
  2. Care Delivery
  3. Information Delivery

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According to Healthcare Informatics, MACRA ends physician payment incentives under the meaningful use program with the HITECH (Health Information Technology for Economic and Clinical Health) Act, and those under the Physician Quality Reporting System (PQRS), replacing the incentives in those programs with a new program called the Merit-Based Incentive Payment Program or “MIPS.

Physicians who miss performance thresholds will be face maximum penalties not to exceed four percent in 2019, five percent in 2020, seven percent in 2021, and nine percent in 2022 and beyond.

In conclusion, MACRA will change the paradigm in our health care system. Under MACRA, physicians will be awarded for providing qualitative care and penalized for underwhelming service and quality of care. MACRA is a win win situation for the physician and patient. This transition in our health care system will provide affordable care, quality care of outcome, and ultimately achieve a system that thrives on positive end results.

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  1. Many docs wary of Medicare reimbursement shift
  2. The Medicare Access & CHIP Reauthorization Act of 2015 – Path to Value
  3. BREAKING: President Obama Signs SGR Repeal Legislation, Shifting Medicare Physician Payment Incentives