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Frequently asked questions

What is MACRA?

In 2015, Congress passed the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA).

MACRA replaced the Sustainable Growth Rate formula and simplified the incentive programs associated with the Medicare Physician Fee schedule. CMS named the new payment system under MACRA the Quality Payment Program (QPP), offering providers two paths to earn value-based payments.

Who is Eligible?

Clinicians who bill professional services under Medicare Part B (Physician Services) are eligible.

  • Physicians, physician assistants (PAs), nurse practitioners, clinical nurse specialists, certified registered nurse anesthetists, and groups that bill under Part B
  • Excludes physicians in small practice settings that do not meet certain billing or encounter thresholds for Part B Medicare services

What are Providers’ Options for Participation

There are two tracks for participation under the QPP

  • Merit-based Incentive Payment System (MIPS)
  • Advanced Alternative Payment Models (A-APMs)

How Will You Know if You Need to Participate in MIPS?

CMS will send letters to clinicians who will be eligible to participate in the MIPS program. If you are eligible and DO NOTHING in 2017, you will receive a 4% reduction in your Medicare payments in 2019.

How Can InterSystems Products Help You Meet the Criteria Under the QPP?

The best product for you depends on which track you are in, MIPS or A-APMs. For details on the two programs and how we help you support them, see page two of our MACRA fact sheet.

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