​The final rule of the Medicare Access and CHIP (Children's Health Insurance Program) Reauthorization Act of 2015 (MACRA) Quality Payment Program will be flexible, simple, and supportive of small practices, according to an October 14, 2016, press release from the Centers for Medicare and Medicaid Services (CMS). MACRA will replace the sustainable growth rate model, which CMS called "flawed," and "will equip clinicians with the tools and flexibility to provide high-quality, patient-centered care." Clinicians will have two paths to transition from fee-for-service healthcare to models that reward quality over quantity. The first path "gives clinicians the opportunity to be paid more for better care and investments that support patients," by "reduc[ing] existing requirements, while still emphasizing and rewarding quality of care." It will also be flexible in the first year, CMS said, to accommodate those who need more time to prepare. The second path "helps clinicians go further by participating in organizations that get paid primarily for keeping people healthy." This includes participation in an Agency for Healthcare Research and Quality (AHRQ)-listed patient safety organization (PSO), such as ECRI Institute PSO. CMS is also launching a new interactive website to help clinicians understand and participate in the program. More information about CMS's final rule is available on its website.

HRC Recommends: Risk managers and quality improvement professionals should be aware that under the program, clinicians eligible for the Merit-Based Incentive Payment System (MIPS) must engage in certain improvement activities or else they will receive a 4% reduction in their Medicare payments. Improvement activities are weighted; eligible clinicians must have four medium-weighted or two high-weighted activities. Participation in an AHRQ-listed PSO, such as ECRI Institute PSO, is one of the "medium-weighted" quality improvement activities listed by the U.S. Department of Health and Human Services.