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In plain terms, clinicians were almost spending more money to treat medicare patients than the government budgeted on paying them based on a formula.

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Medicare Access and Chip Reauthorization Act (MACRA) was enacted as law by President Barack Obama in 2015. The law officially disbanded the SGR model of physician payment.

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Physician Fee Schedule Payment = [(Work RVU x Work GPCI) + (Practice Expense RVU x Practice Expense GPCI) + (Malpractice RVU x Malpractice GPCI)] x Conversion Factor.

The formula has been in use since its conception in 1992 and will end in December 2016. A shift happened in 2002 when the formula allowed for a 4.8% decrease in Medicare payments (Wynne 2015). The SGR formula has called for decrease in payment for every year since 2002, but Congress passed quick fix motions that deferred decreasing Medicare payments known to some as “Doc Fix” (Wynne 2015).

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Watch the video below provided by AthenaHealth to tie all of these concepts together!

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Integrated Care is a worldwide trend in health care reforms and new organizational arrangements focusing on more coordinated and integrated forms of care provision. Integrated care may be seen as a response to the fragmented delivery of health and social services being an acknowledged problem in many health systems.

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The Bundled Payments for Care Improvement (BPCI) initiative is comprised of four broadly defined models of care, which link payments for the multiple services beneficiaries receive during an episode of care. Under the initiative, organizations enter into payment arrangements that include financial and performance accountability for episodes of care. These models may lead to higher quality and more coordinated care at a lower cost to Medicare.

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Defining the Medical Home. A patient-centered philosophy that drives primary care excellence. The medical home is best described as a model or philosophy of primary care that is patient-centered, comprehensive, team-based, coordinated, accessible, and focused on quality and safety.

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Accountable Care Organizations (ACOs) are groups of doctors, hospitals, and other health care providers, who come together voluntarily to give coordinated high quality care to their Medicare patients.

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There are two ways an eligible clinician can receive payment for providing medical services to patients with medicare

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The video starts at :30 seconds. Please Watch from beginning.

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Navigating Payment Reform | athenahealth | PPC

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