The goal of the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) Awareness and Support (MAS) program is to prepare ambulatory practices to succeed under MACRA.  The MAS program aims to educate stakeholders on important information and available resources to support participation in the Merit-based Incentive Payment System (MIPS) and Alternative Payment Models (APMs).  MACRA reformed Medicare health care payments by repealing the sustainable growth rate (SGR) formula and replacing it with a payment structure that aligns to federal reporting programs and links payments to quality and performance.  There are two options for physicians to choose in MACRA, MIPS and APMs.  

MACRA replaces the overlapping Medicare reporting programs, Promoting Interoperability (previously known as Meaningful Use), Physician Quality Reporting System (PQRS), and the value-based modifier (VBM), with MIPS.  In MIPS, providers report performance in four categories: Quality, Promoting Interoperability (previously referred to as Advancing Care Information), Improvement Activities, and Cost. Providers are scored, and receive a positive, negative, or neutral payment adjustment based on their performance in these categories.  

APMs are payment approaches that provide clinicians added incentives to deliver high-quality and cost-efficient care.  Under APMs, payment opportunities include monthly care management fees, bundled payments arrangements, and shared savings. A dvanced APMs are a subset of APMs in which practices are able to earn an automatic five percent incentive payment for taking on some risk related to their patient’s outcomes, and are exempt from MIPS reporting requirements if in a qualifying APM.

The following is a list of resources to assist providers in navigating MACRA.

Online Learning Resources

1. American Medical Association (AMA) MACRA Education
2. Centers for Medicare and Medicaid Services (CMS)
3. Quality Payment Program
4. AMA STEPS Forward 
5. American Academy of Family Physicians (AAFP) MACRA Resources
6. Network for Regional Healthcare Improvement (NHRI) MACRA

Webinars

1. American College of Physicians (ACP)
2. Patient-Centered Primary Care Collaborative Webinars/Video

Online Forum

1. ACP Member Forum on MACRA (Membership required)

Other Resources

1. AMA MACRA Technical Assistance
2. ACP MACRA and the Quality Payment Program
3. Health Quality Indicators (HQI) Resource Center
4. MIPS Calculator

Management Service Organization (MSO)

The MHCC designates Management Service Organizations (MSOs) to support providers in maximizing the use of health IT and achieving practice transformation, which is essential to meeting MACRA requirements.  A list of State Designated MSOs can be found on the MSO webpage.

Practice Transformation Networks

Practice Transformation Networks (PTNs) are peer-networks that help support practices to improve care through the use of electronic health records, care coordination, and patient monitoring to improve health outcomes and reduce hospitalizations.  CMS awarded funding to 29 PTNs as part of the Transforming Clinical Practice Initiative.  Maryland partnered with the New Jersey Innovation Institute to complete the CMS defined practice transformation activities in Maryland.  More information can be found on the Maryland Practice Transformation Network Activities webpage.  A list of PTNs can be found on the CMS Transforming Clinical Practice Initiative website.