MACRA

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Multan College of Education, Multan *

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Nursing

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Nov 24, 2024

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1 Medicare Access and CHIP Reauthorization Act Student’s Name Course Name and Course Number Institution’s Name Instructor’s Name Date

2 In the year 2015, Medicare Access and CHIP Reauthorization Act (MACRA) formulated the Merit-based Incentive Payment System (MIPS) and Advanced Alternative Payment Models (APMs) to cater for physicians’ reimbursement from Medicare to replace the former model (Dearani, 2020). MIPS model applies to most psychologists and primarily focuses on resource use, quality, clinical practice improvement and advancement of the care information. It, therefore, combines the three aspects of the previous stand-alone Medicare program. The MIPS- eligible clinicians must submit data in four categories to receive an all-inclusive composite score. The four categories include quality which is based on the patient outcome; improving activities which is based on changing practice to enhance access to patient-based care, cost which is calculated based on claims score and promoting interoperability which is achieved through the use latest technology of electronic health records system (EHR). The composite score is responsible for the reimbursement or penalty MIPS-eligible clinicians will receive (Rathi & McWilliams, 2019). The second payment structure APMs employs the use of electronic health records technology, quality measures also used in MIPS and the assumption of financial expenditure. Eligible clinicians involved in APMs are exempted from MIPs and qualify for a 5% increase incentive payment. APMs can be compared to medical homes that offer primary care services. Psychologists could be considered as part of APMs but due to their usefulness in traditional Medicare, therefore categorized under MIPS. The quality payment program by MACRA has seen immediate transformational delivery of healthcare services. It has facilitated changing workflow in healthcare facilities from the services offered by nurses and ambulatory to services provided by medical assistance. The changes have resulted to improved patient services (Bazemore et al., 2018).

3 References Bazemore, A., Phillips, R. L., Glazier, R., & Tepper, J. (2018). Advancing primary care through alternative payment models: lessons from the United States & Canada. The Journal of the American Board of Family Medicine , 31 (3), 322-327.Doi: 10.3122/jabfm.2018.03.170297 Dearani, J. A. (2020). Transparency and public reporting: beyond the gathering storm. World Journal for Pediatric and Congenital Heart Surgery , 11 (1), 9-13.Doi: 10.1177/2150135119890514 Rathi, V. K., & McWilliams, J. M. (2019). First-year report cards from the Merit-Based Incentive Payment System (MIPS): what will be learned and what next?. Jama , 321 (12), 1157- 1158.Doi: 10.1001/jama.2019.1295

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