The Medicare Access and CHIP Reauthorization Act (MACRA) changes how Medicare will determine payments to physicians and other health care professionals. The Merit-based Incentive Payment System (MIPS) component starts with the values assigned to individual services and procedures, and computes an eligible clinician’s composite performance score based on Quality, Resource Use, Advancing Care Information and Clinical Practice Improvement Activities. It then applies a positive, neutral or negative adjustment to payments based on that composite score. MACRA also creates incentives for participation in alternative payment models (APM). For more detailed information on the workings of the MACRA Quality Payment Programs, please see www.asahq.org/quality-and-practice-management/macra.

One type of APM is a bundled payment; a bundle can be condition-based or episode-based. Either way, the bundle can encompass all the care provided to a beneficiary during the applicable time frame – across all...

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