Continuing Shift toward Physician Payment for Quality of Care: MACRA

Implementation of a new law that entirely overhauls how Medicare pays physicians will be a major focus for ASN and the entire medical community in 2016. The Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) shifts physician reimbursement away from a fee-for-service system—paying for quantity of care—toward a value-based system that pays for quality of care. Physicians will have choices regarding how they participate in the new reimbursement system, opting either to participate in the “Merit-Based Incentive Payment System” (MIPS) or to participate in an “Alternative Payment Model” (APM).

Although many health professionals will be pleased to hear that MIPS sunsets three existing Medicare programs—the Physician Quality Reporting System, the Value-Based Modifier, and the EHR Meaningful Use program—MIPS will nonetheless assess quality, value, and EHR use in other ways yet to be determined. While MIPS and APMs won’t be operational until 2019, ASN and others aim to work with Medicare to shape these programs to ensure they are as fair and feasible as possible for nephrologists in 2016 and beyond.