MD Learning Channel - Medicine

The Medicare Access and CHIP Reauthorization Act of 2015 (MACRA, aka the “doc fix”) replaced the Sustainable Growth Rate formula, thereby avoiding feared cuts in provider payments. But it also brings significant changes in how Medicare pays physicians while accelerating the shift toward value-based reimbursement. Martin Heslin, MD highlights some of the pros and cons of the new law, including lump-sum payments and other alternative reimbursement models.

Since Medicaid’s Sustainable Growth Rate formula was enacted in 1997, physicians have been adapting and improving to keep pace with cost-control efforts and their impact on compensation. In this video, Martin Heslin, MD explores how that model evolved into quality and satisfaction measures and reimbursement accountability, as implemented through CAHPS surveys and the more recent PQRS metrics.