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June 14, 2016

Implementing MACRA: Implications for Physicians and for Physician Leadership

Author Affiliations
  • 1Duke Clinical Research Institute and Department of Medicine, Duke University, Durham, North Carolina
  • 2Duke-Margolis Center for Health Policy, Duke University, Durham, North Carolina
JAMA. 2016;315(22):2397-2398. doi:10.1001/jama.2016.7041

On April 27, the Centers for Medicare & Medicaid Services (CMS) released the highly anticipated 962-page proposed rule1 for implementing the Medicare Access and CHIP Reauthorization Act (MACRA). MACRA will overhaul Medicare’s physician payment system starting in 2019, placing most physicians in the Merit-Based Incentive Payment System (MIPS), a pay-for-performance system that adjusts payments based on measures derived from prior care. Physicians can be exempt from MIPS and receive bonus payments by demonstrating sufficient participation in advanced alternative payment models (APMs), which are intended to support greater flexibility in care delivery alongside greater accountability for efficiency and care improvement.

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