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Making Way For MACRA: Positioning Your Organization For Payment Reform

In April 2015, Congress passed the Medicare Access and CHIP Reauthorization Act (MACRA), which represents the most sweeping set of changes to Medicare's physician payment methodology since the current system was put in place 25 years ago.

MACRA has made headlines because it repeals the sustainable growth rate (SGR) formula, thereby averting the planned 21% across-the-board cut in Medicare's provider payments. Perhaps more importantly, it represents for Medicare a dramatic step away from traditional fee-for-service (FFS) reimbursement and toward value-based payments for physician service. 

It is critical for providers to appreciate that the post-MACRA landscape will be essentially a zero-sum game that rewards certain providers at the expense of others. Although many of the changes outlined in MACRA will not take effect until 2019, providers who hope to be the most successful under the new payment methodology will need to start the process of planning for and implementing structural changes long before then.

Click here to read the full article, which outlines the key elements of MACRA and its impact on providers that bill Medicare for physician services.

For additional information, please contact the following members of HLB's Medicare Physician Payment Working Group: Robert Lundy (Co-Chair), Charles Oppenheim (Co-Chair) or Karl Schmitz in Los Angeles at 310.551.8111; Ben Durie in San Francisco at 415.875.8500; or William Eck or Martin Corry in Washington, D.C. at 202.580.7700. 

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For media assistance, please contact Maura Fisher at 202-580-7714.