MACRA, MIPS and APMs

Download our helpful visual guide to understand your payment model options!

The Medicare Access and CHIP Reauthorization ACT (MACRA) enacts a new payment framework, the Quality Payment Program (QPP), that rewards healthcare providers for providing better patient outcomes. This visual guide explains the two pathways for determining payment adjustments to eligible providers:

• Merit-based Incentive Payment System, or “MIPS”- reimbusement is based on a composite performance score based on quality, resource use, clinical practice improvement activities and meaningful use of certified electronic health records technology. The payment adjustments can be positive, up to 4%, no adjustment at all, or negative, to as much as -4%.
• Alternative Payment Model, “APMs”- As cited by the Quality Payment Program Service Center "...offers higher reimbursement rates as an incentive to provide high quality and cost-efficient care. APMs can apply to a specific clinical condition, a care episode, or a population." Advanced APM let practices earn up to a 5% incentive by taking on risk related to their patients' outcomes.

Concordance is dedicated to helping primary care providers make the transition from the current fee for service model to the quality based model in an easy and efficient manner. 

Complete the form to access our visual guide!