MACRA, or the Medicare Access and CHIP Reauthorization Act, was signed in April of 2015 and will go into effect on January 1, 2020. MACRA prohibits the sale of Medicare Supplement policies that provide coverage for Part B deductibles (C, F, and High Deductible F). Consequently, newly eligible Medicare beneficiaries will not be able to purchase them. This change will not affect beneficiaries who are already enrolled in C and F.
This is a federal law; it applies to all 50 states.
Another part of MACRA is a new goal to reach a value-based payment system. The goal is to have 50% of Medicare treatment charges based on the quality of service (through alternative payment methods) by the end of 2018.
Everything will go through MIPS, or the Merit-Based Incentive Payment System. Providers will receive a score based on quality, use of resources, practice improvement, and meaningful use of certified technology. That score will determine pay adjustments. Those who are in their first year of Medicare service or are below the patient volume threshold will not operate under this system. It also does not apply to hospitals.
The merit-based system under MACRA means that doctors who provide low-quality care will not earn as much as high-quality doctors. This will push doctors to work harder and treat their patients better. MACRA can reassure your clients who are concerned about care quality! Though the Medicare Supplement part is not yet effective, CMS is working on that goal to have 50% of doctors on a merit-based system by 2018.
Rest assured, the current administration has not touched MACRA – it’s still on track to go into full effect in 2020.