MACRA Resource Center

  • What Is MACRA and the QPP? 

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    Congress passed the Medicare Access and CHIP Reauthorization Act (MACRA) on April 16, 2015, which repealed the Sustainable Growth Rate (SGR) formula used to determine Medicare physician fee-for-service payments. 

    In SGR’s place, MACRA requires physicians to choose between two major payment tracks: the fee-for-service Merit-Based Incentive Payment System (MIPS), and advanced alternative payment models (APMs). To enable this, the Centers for Medicare & Medicaid Services (CMS) created the Quality Payment Program (QPP) to implement the two tracks for eligible physicians and other clinicians.

    The QPP is an annual program that affects Medicare payment two years later. The objective of the program is to incentivize physicians to improve care; reduce costs; and advance health care information among physicians, allied providers, and patients. The third QPP performance year spans Jan. 1 - Dec. 31, 2019. 

    Under the QPP, physicians in MIPS are paid fee-for-service with payment adjustments (incentives or penalties) two years after each performance year. Payment adjustments will vary depending on individual or group performance in four MIPS categories: quality, cost, improvement activities, and promoting interoperability. The payment adjustment in 2021 will be +/-7 percent based on your MIPS score in 2019.

    Physicians who take part in an advanced APM in 2019 are exempt from MIPS and may earn a 5-percent incentive payment for participating in an innovative payment model, in addition to APM-specific rewards.

  • Check Your 2019 QPP Participation Status

    QPP  

    To find out if you are eligible and required to participate in MIPS for the 2019 QPP performance year, check the QPP lookup tool. When you review your profile, take note of any designation assigned to you under “other reporting factors” (e.g., small practice, rural practice, health professional shortage area, facility-based) and learn about what these factors mean to your practice. Physicians required to participate in the 2019 QPP must submit data to CMS by March 31, 2020. If you have questions about your participation status, contact the QPP Service Center at (866) 288-8292, or by email at QPP@cms.hhs.gov.

    Go To QPP Lookup Tool  
  • 2019 QPP Timeline and Important Deadlines 

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    Review the full 2019 QPP timeline and stay on top of MIPS and APM deadlines, snapshots, and milestones.

    See QPP Deadlines  
  • Get MACRA-Ready with TMA Services

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    TMA Practice Consulting offers quality improvement services to help prepare physician practices for MACRA. TMA's practice management consultants can conduct a MACRA readiness assessment of your practice and provide customized on-site assistance to help you with your practice's specific needs. 

    Get TMA Practice Help
  • 2019 MACRA QPP Physician Education Initiative

     

    The Physicians Advocacy Institute, in collaboration with health care consulting firm Healthsperien and TMA, created a MACRA QPP physician education initiative and separate resource center to make the program easier to understand. The website is free, designed for all levels of physician knowledge on the MACRA QPP, and complements TMA’s MACRA Resource Center. Visit the MACRA QPP Resource Center to access free resources and subscribe to the QPP Roundup newsletter.

    Get Free 2019 MACRA QPP Resources  
  • Free QPP Support from TMF Health Quality Institute

     
  • MACRA QPP Webinars and CME

    Learn about MACRA and the QPP and earn CME credits. 

    TMA 2019 Quality Payment Program Webinar Free CME

    CMS Quality Payment Program Webinar Library

    TMF Quality Payment Program Webinars

     

  • MACRA 101: Quality Payment Program

    Learn about the Quality Payment Program using TMA, American Medical Association, and CMS resources and tools. 

    Texas Medical Association

    Medicare QPP Physician Education Initiative

    Alphabet Soup: A MACRA Glossary and Acronym Guide 

    American Medical Association

    Medicare Quality Payment Program

    Centers for Medicare & Medicaid Services

    Quality Payment Program: Merit-based Incentive Payment System and Alternative Payment Models

    Help and Support, Support and Available Options for Small, Underserved, and Rural Practices

    QPP Resource Library, QPP Portal, Timeline and Important Deadlines

    U.S. Department of Health & Human Services

    How to Propose Your Own Physician-Focused Payment Model under MACRA

  • TMA MACRA News and Advocacy

    TMA to Congress: Undo Payment Freeze, Help Physicians With MACRA Texas Medicine Today, June 11, 2019

    Texans Invite AMA to Join Crusade to Fix QPP Texas Medicine Today, June 4, 2019

    False Impression: Medicine Says Medicare Report Inflates Success of Quality Program Texas Medicine, June 2019

    Medicine to CMS: Medicare Report Inflates Success of Quality Program Texas Medicine Today, May 1, 2019

    Get Awarded For Your Quality Work in 2018 Texas Medicine Today, Apr. 12, 2019

    Unfair Playing Field? QPP Scoring May Hurt Physicians Not Hospital-Affiliated Texas Medicine Today, Apr. 11, 2019

    How to Avoid MIPS Penalty with Minimal Reporting by April 2 Texas Medicine Today, March 25, 2019

    Free MIPS Help from TMF Health Quality Institute Texas Medicine Today, March 22, 2019

    Deadline to Submit 2018 MIPS Data is April 2 Texas Medicine Today, March 12, 2019

    CMS Working to Correct MIPS Payment Errors Texas Medicine Today, March 5, 2019

    Check for MIPS Payment Adjustment Errors Texas Medicine Today, Feb. 4, 2019

    Making the CEHRT Switch: EHR Upgrade Required for Incentive Payment Programs Texas Medicine, Jan. 2019

    Buying Time: Medicine’s Warnings Prompt CMS to Delay Dramatic Coding and Payment Changes Texas Medicine, Jan. 2019

    New Rules, Free CME: 2019 Medicare Payments Texas Medicine Today, Dec. 18, 2018 

    Read More About MACRA

  • MACRA Help from the Feds

    Explore the list of federally funded initiatives to help you transition to MIPS or APMs. All services are available to physicians and group practices at no or low cost.

    CMS Quality Payment Program Help and Support

    Quality Payment Program – Small, Underserved, & Rural Support

    TMF Quality Payment Program Network

    Transforming Clinical Practice Initiative

    Health Care Payment Learning and Action Network

    The Innovation Center’s Learning Systems

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    TMA is helping to strengthen your practice by offering advice and creating a climate of medical success across the state. 

  • What could a TMA membership mean for you, your practice, and your patients?