MACRA (Medicare Access & CHIP Reauthorization Act)

(Medicare Access & CHIP Reauthorization Act)

In November 2015, 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:

Download our MIPS 2020 Guide Register for MIPS Webinars

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

Congratulations to TSI Healthcare Small Practices!

In 2018, 100% of clients using our Quality Program Services received the exceptional performer bonus.

Quality Payment Program

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

 Download 2020 MIPS Infographic



Merit-Based Incentive Payment System

  • Combines Meaningful Use, PQRS/CQMs & VBM
  • Measures Providers On:
    • Quality
    • Promoting Interoperability (Use of EHR)
    • Improvement Activities
    • Cost
  • Financial Implications
    • Can Receive Positive Payment Adjustments Based On MIPS Score
    • Can Earn Up To 7% Max Penalty For Not Meeting 2019 MIPS Requirements

Advanced Alternative Payment Models

  • Requires 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 continue in 2019 as the third performance year with payment adjustments beginning in 2021.

MIPS Year 4 Program Overview

The new quality program structure increases emphasis on interoperability and quality, while decreasing patient costs.


Quality = 45%

Learn More

MACRA Screen

Promoting Interoperability = 25%

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MACRA Clipboard

Activities = 15%

Learn More


MACRA Money SIgn

Cost = 15%

Learn More

Introducing Quality Program Services

Overwhelmed by MACRA and MIPS? Stress no more!
TSI Healthcare’s revolutionary new approach to federal policy assistance provides you with the next level of
regulatory assistance and client advocacy.

QP Central

An online resource center to help practices navigate the new MIPS requirements.

Workflow Workshops

Workflow “how-to” videos for easy learning on the fly for role-specific and specialty-specific measures.

Guided Assistance

Guided assistance with hands-on regulatory training from a Quality Program Specialist allows you to focus on patient care.

  • "As government regulations continue to evolve, TSI Healthcare remains current regarding the changes and always keeps us informed in a prompt manner."

    Ana, Director of Clinical PracticeArthritis & Rheumatism Associates, M.D.
  • "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 Government Affairs 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
  • “There are a lot of changes coming with the new MIPS and MACRA programs for Medicare, and there is no way I could possibly stay on top of it and run a medical practice. We rely very heavily on the Government Regulations team at TSI Healthcare. Our practice greatly benefits from their knowledge about MACRA. They stay on top of the changes and help us navigate them.”

    Connie, Director of Business OperationsCape Fear Arthritis Care
  • "TSI Healthcare’s rheumatology specific EHR is very manageable to use, and their reporting system is very flexible. We are on track for meaningful use, and it has allowed us to enjoy a significant increase in revenue. This has let us add to staff and incorporate an ultrasound machine.”

    Kevin Hicks, MDCollaborative Arthritis Care, Inc.
  • "TSI Healthcare is top-notch when it comes to federal policy guidance. They help us with attestation and they explain the government regulations."

    Hope, System Support & Implementation MangerTidewater Physicians Multispecialty Group, P.C.