MACRA
The Medicare Access and CHIP Reauthorization Act is the 2015 law that created the Quality Payment Program, including the MIPS and Advanced APM tracks.
Updated
MACRA replaced the sustainable growth rate formula for physician payment and established the Quality Payment Program, offering two participation paths: the Merit-based Incentive Payment System (MIPS) and Advanced Alternative Payment Models (APMs).
The law shifted Medicare clinician reimbursement toward value-based payment tied to quality and cost performance rather than volume alone.
In practice
Revenue cycle teams align reporting and documentation strategies with the appropriate MACRA track so that performance data supports payment adjustments under the chosen participation path.
Commonly confused with
- MIPS: MIPS is one of the incentive programs MACRA created; MACRA refers to the legislation itself, while MIPS is the operational program that adjusts payment under it.