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November 2017

MACRA and Cardiology—The Devil Is in the Details

Author Affiliations
  • 1Division of Cardiovascular Medicine, Brigham and Women’s Hospital, Boston, Massachusetts
  • 2Department of Health Care Policy, Harvard Medical School, Boston, Massachusetts
  • 3Harvard T. H. Chan School of Public Health, Boston, Massachusetts
JAMA Cardiol. 2017;2(11):1177-1178. doi:10.1001/jamacardio.2017.2412

After passing both houses of Congress with broad, bipartisan support, the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) was signed into law on April 16, 2015. As has been well publicized, MACRA changes the way Medicare pays physicians, repealing the sustainable growth rate (an aspect applauded by many cardiologists1), locking physician fee schedule growth near 0, and creating a new Quality Payment Program (QPP) to adjust physician payment. The US Centers for Medicare and Medicaid Services argues that these changes shift payment away from volume and toward value. However, there are a number of design features that create uncertainty and concern about how QPP will affect cardiologists.

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