The Medicare Access and CHIP Reauthorization Program (MACRA)

What is MACRA?

The Medicare Access and CHIP Reauthorization Program, or MACRA, is a payment plan that Congress created to replace the sustainable growth rate formula (SGR) and the Meaningful Use program. Recently, the Center for Medicare and Medicaid Services (CMS) released its set of proposed rules for this new set of payment guidelines.

MIPS and APM

Under MACRA, there will be two payment options, and the rules for each will apply depending on the option for which your practice qualifies. Unless your practice falls under a small group of classifications including Comprehensive Primary Care Plus (CPCP+) and some Patient-Centered Medical Homes, you will likely not qualify for the Alternative Payment Model. For those who do, visit http://www.ama-assn.org/ama/pub/advocacy/topics/medicare-alternative-payment-models.page for more information about what MACRA means for you.

Most healthcare providers will fall under the Merit-Based Incentive Payment System (MIPS) option functions using a system whereby the CMS will put a positive, neutral, or negative stamp on your practice based on these four groups of metrics: Quality, Resource Use, Clinical Practice Improvement Activities, and Advancing Care Information. Based on the “grade” your practice receives by these measurements, your practice will either enjoy up to 4% extra in Medicare reimbursement during the first year and up to 9% extra in 2022, or suffer negative adjustments to reimbursement. Because MIPS is budget neutral, the upward adjustments given to practices with positive rankings will be offset by downward adjustments on poorly performing practices.

MACRA and Praxis

What does all of this mean for your practice? In short, MACRA requires metrics and powerful EMR/EHR technology that allows you to keep track of records and communicate with patients as efficiently and effectively as possible. As the influx of ever-changing regulations and requirements show, your EMR needs to adapt to your needs. Praxis is the only HER that tracks MACRA parameters for you automatically. Then, Praxis' template-free technology allows you to query your records for any clinical parameter you wish, so that you are prepared for whatever reporting requirements may arise. Because you are never limited by a predefined set of options, you have the power to adapt to new reporting guidelines like MACRA's without waiting for software updates and new templates.


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