Medicare Access and CHIP Reauthorization Act of 2015 (MACRA)
The Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) is federal law that repealed the sustainable growth rate formula and established the Quality Payment Program, tying physician reimbursement to performance through MIPS and advanced alternative payment models.
What is the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA)?
The Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) is a federal law that overhauled how Medicare pays physicians. It repealed the long-criticized sustainable growth rate formula, which had repeatedly threatened steep payment cuts, and replaced it with a framework that ties reimbursement to performance.
MACRA established the Quality Payment Program, under which clinicians participate either through the Merit-based Incentive Payment System (MIPS) or through advanced alternative payment models. Both pathways link a clinician's Medicare payments to measures of quality, cost, and value rather than volume alone.
Why does MACRA matter?
MACRA marked a durable shift toward value-based reimbursement, making physician payment contingent on demonstrating quality and efficiency. For clinicians, performance under MIPS or participation in advanced alternative payment models can mean meaningful upward or downward adjustments to Medicare payments.
The law's emphasis on reporting and performance has reshaped administrative expectations across practices and facilities. Understanding which pathway applies, and managing the associated measures and documentation, has become part of operating sustainably under Medicare.
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