The Medicare Access and CHIP Reauthorization Act (MACRA) was passed in April 2015 with the bipartisan support of Congress. MACRA replaces the unpopular Sustainable Growth Rate formula for adjustment of Medicare payments to physicians. MACRA is intended to accelerate the transition from volume to value-based payments. MACRA outlines two pathways in its Quality Payment Program.

The first pathway, known as Alternative Payment Models (APMs), may apply to some practices participating in arrangements that include, but are not limited to, Accountable Care Organizations. Advanced APMs, a subset of this first pathway, applies to groups with greater than 25 percent of their payments coming through certain payment models featuring two-way risk sharing. This is something few, if any, anesthesia groups will achieve in the near future.

The second pathway is the Merit-Based Incentive Payment System (MIPS). MIPS applies positive incentive payments or negative payment withholds in a budget-neutral fashion (i.e., the losers...

You do not currently have access to this content.