Essay on The Medicare Access And Chip Reauthorization Act Of 2015
Effective Jan. 1, 2017, how you participate with this new program determines whether your future Medicare reimbursement will be increased or decreased. It all depends on the data you submit. And although the data submission requirements are somewhat based on several quality reporting systems you may be familiar with (Physician Quality Reporting System (PQRS), Meaningful Use (MU), Value-Based Modifier (VBM), etc.), don’t be fooled into thinking it’s business as usual. If you don’t follow the new MACRA guidelines carefully, your future income will be reduced by as much as 9%.
MACRA makes three important changes to the way you’re paid by Medicare:
1. Sunsets Sustainable Growth Rate (SGR) methodology: MACRA replaces the SGR, which is what CMS has used to determine your Standard Medicare Payment Rate. For each of the next three years, you will receive a 0.5% pay increase. And then from 2020-2025, there will be no increase in the Standard Medicare Payment Rate. And finally, after 2025, there will be an annual increase of 0.25% to 0.75%.
2. Payment based on performance instead of simply volume of services provided: The MACRA system creates a new framework for rewarding healthcare providers for giving better care (value-for-service). This replaces the current method of paying for frequency (fee-for-service). This mean that you will no longer be…