For those following Medicare payment reform last April the MACRA (Medicare Access and CHIP Reauthorization Act) was passed by Congress and signed into law by the President. Title I of the law reforms how Medicare physician payments are annually updated, i.e., the law replaces the 1997 Sustainable Growth Rate. The proposed MACRA rule, that CMS will publish sometime over the next few to several weeks, is highly anticipated because beginning in 2019 physicians and other eligible professionals can face significant increases or decreases in their annual payment update depending how they perform on quality and/or value under the two MACRA-created payment update pathways: MIPS (the Merit-based Incentive Payment System) and APMs (Alternative Payment Models). If you're interested in theses provisions of the law and what we might see in the proposed rule, feel free to read this essay posted April 6th on The Health Care Blog.