Posted by Anne Phelps, US Health Care Regulatory Leader, Principal, Deloitte & Touche LLP, Daniel Esquibel, Senior Manager, Deloitte & Touche LLP, and Heather Hagan, Senior Manager, Deloitte & Touche LLP, on October 17, 2016
The Centers for Medicare and Medicaid Services (CMS), on Friday, October 14, 2016, issued the heavily anticipated final rule on the Merit-based Incentive Payment System (MIPS) and Alternative Payment Model (APM) Incentive under the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA). Together, CMS is referring to the new payment tracks through MIPS and Advanced APMs as the Quality Payment Program (QPP).
MACRA repealed the sustainable growth rate (SGR) formula for updates to the Medicare Physician Fee Schedule and sets payment updates for all years in the future. Through the QPP, the law is intended to link Medicare payment updates to quality and performance and drive the health care payment system across all payers away from fee-for-service reimbursement models.
The first performance period under MACRA will begin on January 1, 2017, and the first payment adjustments under the law will take effect for 2019.