Medicare Compliance & Reimbursement - 2016 Issue 17
Breaking News: MACRA Boosts Its Capital By Putting Value and Quality First
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Article Overview
This article covers a proposed Medicare payment overhaul tied to MACRA and the Quality Payment Program. It summarizes the major program structure, the two payment pathways, the kinds of existing Medicare initiatives being incorporated or revised, and the proposed timeline for Part B participation, reporting, and stakeholder feedback. It is relevant to clinicians, coders, compliance staff, and practice leaders who need a high-level understanding of how the new payment model is being framed and what agencies are involved.
Why This Topic Matters
The proposed changes affect how Medicare payment will be evaluated and adjusted for many providers, so understanding the program’s scope and timing is important for compliance, planning, and operational readiness.
Article Sections
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HHS proposes the Quality Payment Program framework
Introduces the federal proposal and the broader policy shift behind Medicare’s new payment approach. It also places the announcement in the context of prior research, commentary, and review.
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Background and program context
Summarizes the legislative and program background that informed the proposal. It references earlier Medicare quality and incentive initiatives that were adapted into the new framework.
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Understanding the two options
Describes the two main pathways in the proposed system and the overall purpose of each. It also notes the performance areas that factor into the program structure.
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What this means for Part B
Explains the proposed impact on Part B providers, including reporting timing and payment adjustment themes. It also mentions the CMS listening session, public comment period, and available resources.
What You Will Learn
- How the proposed Medicare Quality Payment Program is organized at a high level
- Which earlier Medicare quality initiatives are being carried forward or revised
- What the two major payment pathways are in the proposal
- How the proposal is framed for Part B providers and the expected timeline
- Where CMS is seeking feedback and additional program information
Who Should Read This
- Medical coders
- Billing and reimbursement professionals
- Compliance staff
- Physician practice administrators
- Clinicians participating in Medicare
- Health policy and revenue cycle teams
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