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What is MACRA?

The Medicare Access and CHIP Reauthorization Act (MACRA) was signed on April 16, 2015 and replaces the current medicare reimbursement schedule and ends the Sustainable Growth Rate formula with a new pay-for-performance program focusing on quality, value, and accountability replacing the previous fee-for-service model.

Fee-for-Service Pay-for-Performance

MACRA replaced the Physician Quality Reporting System (PQRS), Value-based Payment Modifier (VBM), and the Medicare Electronic Health Record (EHR) incentive program and tries to simplify them into one new Quality Payment Program (QPP) with two paths: the Merit-based Incentive Payment System (MIPS) and Advanced Alternative Payment Models.

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What is MIPS?

The Merit-Based Incentive Payment System (MIPS) will have it's first performance year starting on January 1, 2017. This means your practice will begin a 2 year performance test measuring your practice's eligible professionals (EPs) and giving them a “MIPS score” between 0 and 100. Going forward from 2019 this impacts an individual provider’s Medicare reimbursement by increasing reimbursement by 27% or decreasing it by 9%. About 90% of Eligible Professionals (EPs) will qualify of the MIPS track and APMs are still in experimentation.

  • Increasing Reimbursement by 27%
  • Decreasing Reimbursement by 9%
  • With DrChrono you can instantly begin attesting during the first performance period for MIPS in 2017.

MIPS ties in previous initiatives (MU,PQRS,VBM) into weighted categories to provide this score :

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Quality (PQRS/VBM)
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Advancing Care Information(MU)
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Clinical Practice Improvement

Am I included in MIPS?

To check if you are included or exempt for MIPS, please use this free National Provider Identifier (NPI) search.

What is APM?

The Alternative Payment Model (APM) is a shared risk model that allows practices to earn more by tying more payment to patient outcomes. One immediate benefit from participating in Advanced APMs is a 5% Medicare incentive payment during 2019 through 2024.


timeline Jan 2017-Jan 2019

Want to Learn More?

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The basics of MACRA/MIPS

President Obama signed into law the Medicare Access and CHIP Reauthorization Act (MACRA) on April 16, 2015.

Impact graphs of macra and mips

Am I Included in MIPS?

Find out your participation status via the Quality Payment Program site

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