Background: In the spring of 2015, Congress passed and the President signed into law the Medicare Access and CHIP Reauthorization Act (MACRA), which sets Medicare physician payment on a new course and will result in significant policy changes in the next few years. MACRA was the result of a bi-partisan effort to address nearly two decades of scheduled cuts to Medicare Physician Fee Schedule (PFS) payments due to the Sustainable Growth Rate (SGR) formula.


  • In addition to repealing the SGR, MACRA provides modest but stable payment increases of 0.5 percent annually from 2015 through 2019.
  • MACRA establishes the Merit-Based Incentive Payment System (MIPS), which consolidates three Medicare physician quality reporting programs (Physician Quality Reporting System, Value-Based Payment Modifier, and Meaningful Use of EHRs). MIPS is the default program for Medicare physicians.
  • Those in advanced alternative payment models (APMs) are exempt from MIPS and eligible to earn an annual 5% bonus from 2019 through 2024 based on Medicare PFS payments.

News and Advocacy

  • NAACOS submits comments to CMS on MACRA Final Rule with Comment Period

  • CMS releases final MACRA rule
    • New CMS webpage that includes final MACRA rule, Executive Summary and Resource on Advanced APMs for 2017
    • NAACOS releases in-depth analysis of the final MACRA regulation, customized specifically for ACOs. To obtain a copy of this in-depth analysis, please visit this webpage
    • NAACOS is hosting a four-part MACRA webinar series in November and December, including webinars on: MACRA Overview for ACOs, Deep Dive on Advanced APMs, Deep Dive on MIPS, and Discussion and Planning for the Future. They are available on-demand here.
  • CMS blog announces new flexibility for 2017 MACRA reporting

  • NAACOS comments to CMS on proposed MACRA regulation

  • NAACOS outlines initial statement with concerns about CMS’s MACRA proposed rule

  • CMS releases major MACRA proposed rule (and overview)

  • NAACOS' Advanced Payment Model (APM) Talking Points 

  • NAACOS comments on CMS’ MACRA request for information 

  • CRS summary of the Medicare Access and CHIP Reauthorization Act (MACRA) of 2015 

To read more about developments related to MACRA and other key policy issues effecting ACOs, please visit our newsletter web page.              

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