MACRA stands for Medicare Access and Reauthorization Act of 2015. Essentially, MACRA established new ways to pay physicians for care for Medicare beneficiaries. It was signed into law in 2015 to replace the Sustainable Growth Rate formula for healthcare provider reimbursement. Under MACRA, providers that participate in Medicare will be paid on the quality and effectiveness of the care they provide. With the implementation of MACRA came the Quality Payment Program, which is a reward system that pays based on value over volume. QPP involves two major value-based tracks for doctors to earn payments. The doctor must choose one of the following:
-merit based incentive payment system which rates providers annually on clinical quality, information technology use, clinical practice improvement and resources use.
-advanced alternative payment models. Through APM’s, practices earn more by taking on additional risk patients, such as those with end stage renal disease or cancer.
There are some things Medicare beneficiaries need to be aware of about MACRA starting in 2020.
- New Medicare beneficiaries will no longer be offered $0 deductible Medigap plans.
- Anyone who is currently on Original Medicare (either Part A or B or both) will be able to purchase Plans F, C or high deducible F through December 31, 2019.
- Starting January 1, 2020, anyone who is enrolling in Medicare for the first time will not be able to purchase Plans F, C, or high deductible F.
If you have questions or are confused about which company is best for you, book a meeting with an agent. The goal is to lower your potential cost as low as possible while still receiving great medical care when you need it.
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