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The SGR is History: What Physicians Need to Know

    • SGR

      Key Payment provisions of the Medicare Access and CHIP Reauthorization Act and a look at what comes next.

      MIPS Performance Year is likely to be 2017!

      The Medicare Access and CHIP Reauthorization Act of 2015 (MACRA, Public Law 114-10), which finally repealed the sustainable growth rate formula (SGR), includes provisions that will significantly affect the way physicians practice and get paid for caring for Medicare patients. Although physicians have the option of continuing in the traditional fee-for-service Medicare program, doing so has implications under the new law.

      Here are some important provisions that physicians need to know:

      Key Payment Provisions of MACRA

      • Immediately repeals the SGR.
      • Provides annual payment increases of 0.5% for all physicians paid under the physician fee schedule through 2019.
      • Base payment updates for years 2020 – 2025 scheduled at 0.0%.
      • Physicians who participate in an Alternative Payment Model (APM) receive a 5% annual bonus from 2019 – 2024.
      • Beginning in 2019, base payment rates for physicians who choose not to participate in an APM will be adjusted based on performance under the Merit-based Incentive Payment System (MIPS).

       

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