MACRA (Medicare Access & CHIP Reauthorization Act)

(Medicare Access & CHIP Reauthorization Act)

In October, The Centers for Medicare & Medicaid Services (CMS) released the final rule for MACRA, altering how Medicare reimburses clinicians and their practices. It emphasizes quality, value, and clinicians taking more financial risk.

TSI Healthcare® is here to help you navigate through the murky waters of federal regulations.

Be sure to check out our other resources:

Informational Webinars MACRA Blog Series Download MACRA Infographic

What’s The Big Idea?

With a stronger emphasis on quality, value, and bigger financial risk, there are three key areas MACRA seeks to address.


Repeals SGR

Sustainable Growth Rate


Shifts from Volume to Quality

Shift from fee-for-service
to pay-for-quality


Extends CHIP

Children’s Health
Insurance Program

Quality Payment Program

MACRA’s Quality Payment Program will allow providers to select between two quality payment program.



Merit-Based Incentive Payment System

  • Combines Meaningful Use, PQRS/CQMs & VBM
  • Measures Providers On:
    • Quality
    • Advancing Care Information (Use of EHR)
    • NEW Improvement Activities
    • Cost (coming in 2018)
  • Financial Implications
    • Can Receive Negative or Positive Payment Adjustments Based On MIPS Score
    • Can Earn Up to 22% Bonus (for exceptional performers) Or 4% Max Penalty

Advanced Alternative Payment Models

  • Must Require Certified EHR Use
  • Must Base Payment On Quality Measures Comparable To MIPS Quality Category
  • Must Bear Financial Risk
  • Financial Implications:
    • Must Bear Financial Risk
    • Can Earn 5% Bonus


MIPS will begin in 2017 as its first performance year with payment adjustments beginning in 2019.

MIPS Program Overview

MIPS combines MU, PQRS, and VBM to measure clinicians in four different categories. The new quality program structure increases emphasis on PQRS while decreasing it on Meaningful Use.

MACRA Pie Chart


Quality = 2017 – 60%,
2018 – 50%

Learn More

MACRA Screen

Advancing Care
Information = 25%

Learn More

MACRA Clipboard

Activities = 15%

Learn More


MACRA Money SIgn

Cost = 2017 – 0%,
2018 – 10%

Learn More

More Exciting News

MACRA proposes more exciting reporting and data submission options.

Group Reporting


Increased Flexibility With Pick Your Pace


No Longer All or Nothing


Webinar: MACRA 101 

With multiple new additions for reporting categories and options to participate in either MIPS or Advanced APMs, practices are encouraged to watch this webinar to learn more about the new payment structure.

  • "One of the main challenges that any practice has had in the last 3 or 4 years is being ready for Meaningful Use 1 and now Meaningful Use 2. TSI Healthcare is very knowledgeable and well versed. They have an excellent staff that can help with the regulations and changes that are needed. They are there to support you. We wouldn't be where we are today without TSI Healthcare's help."

    Jason Rubinstein, Practice AdministratorCentral Florida Retina
  • "TSI Healthcare has introduced a little bit more ease of use as far as EHR goes, and Meaningful Use especially. They've done a really good job of helping us meet our Meaningful Use goals and getting paid for Meaningful Use."

    Robert Collins, Director of OperationsBoston Laser Eye Institute, P.C.
  • "We truly have a partnership with TSI Healthcare. For me, the greatest assets have been the implementation team that helped us bring the whole process into the office. The Meaningful Use team has really helped us navigate through all of the regulatory requirements to receive our bonuses and to make sure that we are using our EHR the way it was designed to be used."

    Robert Stutman, OD, MBA, FAAOSelect Eye Care
  • "One of the things that we couldn't live without is the Meaningful Use team. They have held our hands from the beginning, and we could definitely not live without them. Also, the support team and access to their help. From the beginning, this was something we found so important to us."

    Lynne MarletteThe Hirsh Center

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