MACRA (The Quality Payment Program)

APM Alternative Payment Model

SGR (sustainable Growth Rate repealed April, 2015

PQRS

Meaningful Use

Value-Based Payment Modifier

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MIPS (Merit-Based Incentive Payment System)

Payment adjustment based on performance in 4 categories

Advancing Care Information/Use of CEHRT (25%) (meaningful Use)

Clinical Practice Improvement Activities (15%)

Quality (50%) (PQRS)

Resource Use/Cost (QRUR)

Qualify based on 3 requirements

Base Payments on quality measures comparable to MIPS

Require providers to bear more than nominal risk

Use Certified EHR technology

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APM's must also be an approved model by CMS

CMS approved APM's

Comprehensive Primary Care Plus Model

Medicare Shared Savings Program Tracks 2 and 3

Comprehensive ESRD Care Model (LDO and non-LDO two-sided risk arrangements)

Next Generation ACO model