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MACRA Fact Sheet

The MACRA (Medicare Access and CHIP Reauthorization Act) replaces the fee-for-service system with a focus on quality patient care and efficiency, utilizing the Quality Payment Program that includes MIPS and APMs. It aims to improve clinical care and patient-provider interactions by promoting data sharing and collaboration, ultimately enhancing health outcomes. The MIPS system adjusts payments based on a composite performance score, incentivizing healthcare providers to improve their practices.

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21 views5 pages

MACRA Fact Sheet

The MACRA (Medicare Access and CHIP Reauthorization Act) replaces the fee-for-service system with a focus on quality patient care and efficiency, utilizing the Quality Payment Program that includes MIPS and APMs. It aims to improve clinical care and patient-provider interactions by promoting data sharing and collaboration, ultimately enhancing health outcomes. The MIPS system adjusts payments based on a composite performance score, incentivizing healthcare providers to improve their practices.

Uploaded by

jared
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOCX, PDF, TXT or read online on Scribd
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MACRA Fact Sheet

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MACRA Fact Sheet

The policy one selected is the MACRA (Medicare Access and CHIP Reauthorization

Act). The MACRA policy was invented to eliminate a system known as the fee for service

system, and it replaced it with a system that embraces patient care and efficiency. The MACRA

policy ensures that the health care providers are paid based on the quality of care and services

they have provided (Bapat et al., 2019). The MACRA policy also ensures that it provides quality

care by ensuring that the reporting programs are in one program. It is also equipped with various

programs to ensure that a quality payment program is achieved (Bapat et al., 2019). For example,

the Quality Payment Program uses two paths, the Merit-Based Incentive Payment Systems

(MIPS) and the Alternative Payment Models (APMs).

Impact of Policy on System Implementation

MACRA ensures a sustainable growth rate by adjusting the expenditure growth rate. It

also authorizes some programs to implement some initiatives to improve access to health care

services (Hussey et al., 2017). The new policy also aims to streamline the programs under one

wing to improve patient care provision.

Impact of MACRA On Clinical Care, Patient/Provider Interactions, and Workflow

The clinical care will allow the clinicians under the MIPS to embrace measures that fit

into their practices and improve the patient's health care (Hussey et al., 2017). The measures

include; the use of patient electronic access and the enhancing of care by engaging with the

patient and allowing a free flow of information regarding the patient's health.

The MACRA policy also comes in handy with various measurements that aid in

improving patient-centered quality care. It is achieved by the significant collection of the


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patient's data, which includes; patient's medical history and family history in order to determine

the right medical diagnosis (Hussey et al., 2017). The policy also allows the free flow of

information by providing patient's access, and it also allows the exchange of the patient's

information through various health technologies to ensure that the patient gets maximum health

care.

The MACRA policy also enhances positive interaction between the health care providers

and the patients. It is because the policy allows the collaboration of these two parties. Also, by

engaging all the parties in decision-making, patient experiences will help provide proper medical

interventions that will improve the patient's well-being (Hussey et al., 2017). Family members'

presence provides psychological support to the patient and improves the patient's overall health

outcomes.

The MACRA workflow is based on the quality payment program, which uses two

programs; the MIPS and the APM. The physicians and the clinicians in the MIPS program will

only receive a bonus or penalty based on a composite score, in that the better a health care

provider performs, the higher the bonus one attains (Unroe et al., 2017). The health care

providers can also participate under the APM program, in that it allows them to get a specific

percentage of bonus for the health care services they have provided.

Policies That Will be in Place at Will be in Place at One's Healthcare

Merit-Based Incentive Payments (MIPS)

The MIPS system entails various systems that include the Value-Based Payment

Modifier (VBM) and the Physicians Quality Reporting Systems (PQRS). This policy determines

the payment policy by making some adjustments through the composite performance score.
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Based on the score, one will receive bonuses, payments, or no payment at all (Unroe et al.,

2017). It also includes some activities that help improve clinical care and practice; they include;

care coordination, beneficiary engagement, patient safety and assessment, and the achieving of

health care equity.


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References

Bapat, B., Smith, Y., Klink, A., Nabhan, C., & Feinberg, B. A. (2019). Community

oncologists perceptions and readiness to implement Medicare access and CHIP

Reauthorization Act (MACRA). Journal of Clinical Oncology, 37(15_suppl),

e18374-e18374. https://doi.org/10.1200/jco.2019.37.15_suppl.e18374

Hussey, P. S., Liu, J. L., & White, C. (2017). The Medicare access and CHIP

Reauthorization Act: Effects on Medicare payment policy and spending. Health

Affairs, 36(4), 697-705. https://doi.org/10.1377/hlthaff.2016.0559

Unroe, K. T., Hollmann, P. A., Goldstein, A. C., & Malone, M. L. (2017). Medicare access

and CHIP Reauthorization Act: What do geriatrics healthcare professionals need to

know about the quality payment program? Journal of the American Geriatrics

Society, 65(4), 674-679. https://doi.org/10.1111/jgs.14765

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