While at the National MACRA MIPS/APM Summit in Washington, D.C., I heard much discussion centered on how to create and implement strategies that pay physicians fairly, while controlling spending in the Medicare program. It’s a question we’ve wrestled with for almost 20 years and a challenge we must solve.

The Medicare Access and CHIP Reauthorization Act (MACRA) of 2015 replaces the Sustainable Growth Rate, which was almost universally hated because of annual threats of cuts in physician payments. The merit-based incentive payment system (MIPS), the default portion of MACRA, seeks to retain the basic fee-for-service payment structure and stabilize physician payments, while at the same time requiring adjustments to the size of the payments based on a physician’s ability to improve performance and control costs. The alternative payment model (APM) track is designed for providers who are already operating value-based models. Ultimately, MACRA is designed to create a healthy business model for physicians while also creating healthy populations.

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