In late April, the Centers for Medicare & Medicaid Services (CMS) released its proposed rule for the Medicare Access and CHIP Reauthorization Act (MACRA). As described in previous articles and on the ASA website, MACRA will alter how CMS pays physicians and medical professionals as the agency emphasizes pay-for-value rather than the pay-for-reporting and pay-for-performance world that most anesthesiologists have operated under for some time. But before moving onto MACRA, let’s revisit 2014 and how some of the proposed MACRA rules are likely a reflection of both the challenges and successes physicians had under the Physician Quality Reporting System (PQRS).

In 2014, CMS dramatically raised the bar for participation in PQRS from previous years by increasing reporting requirements from three measures across one National Quality Strategy (NQS) domain to reporting nine measures across three NQS domains. Although the Measure-Applicability...

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