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The Medicare Access and CHIP Reauthorization Act (MACRA) has neither fueled growth in alternative payment models (APMs) nor has it imposed any significant payment differential based on value in the Merit-based Incentive Payment System (MIPS). Currently, the maximum increase MIPS offers is 1.86%, and in 2018, nearly all (98%) eligible clinicians had a positive MIPS adjustment, which shows there are no meaningful incentives for value in MIPS. In APM growth you would be hard-pressed to identify where MACRA kicked in if you were looking at Medicare Shared Savings Program (MSSP) growth.
In case you were wondering, MACRA was finalized in November 2016, so its incentives would have affected 2018 MSSP participation most directly. At the same time, we know from MSSP that physician groups can come together around value, maintain their independence, increase qualityo of care, and reduce health care costs.
By taking the lessons learned over the last 5 years, MACRA can be reimagined to live up to its promise.