American Society of Plastic Surgeons
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MACRA

Reshaping Medicare Payment

The Quality Payment Program (QPP) final rule for 2018 was recently released and continues to build and improve upon CMS’ transition year policies as well as address elements of MACRA that were not included in the first year of the program. There are changes that will impact small practices as well as solo practitioners including new performance category scoring, flexible participation options and additional bonus options.



The Medicare and CHIP Access and Reauthorization Act (MACRA) was signed into law in April 2015, replacing the long-dysfunctional sustainable growth rate (SGR) for updating Medicare payments to physicians. While moving past the SGR – and the annual threat of double digit cuts in Medicare reimbursement rates it carried – was a step forward, MACRA represents a sea change in Medicare payment policy.

The complexity and scope of the law and the new Quality Payment Program (QPP) it creates present a significant challenge to practicing physicians. ASPS has created these pages to help you learn about MACRA and find resources that can help you successfully participate in the new system it has ushered in.

Prior to release of the final rule implementing MACRA, ASPS took numerous steps in 2015-2016 to influence the rule making process as the Centers for Medicare and Medicaid Services (CMS) developed the Medicare Access and CHIP Reauthorization Act, including:

MACRA Request for Information (RFI)

Quality Measure Development

MACRA Oversight Hearings

  • Submitted ASPS testimony and helped develop Alliance testimony to the House Energy & Commerce Committee
  • Assisted in crafting a list of recommended questions for the House Ways & Means Committee on behalf of the Alliance
  • Directed ASPS comments to the Senate Finance Committee and assisted in the development of the Alliance's comments

Additional Comments

  • Critiqued CMS's proposal for episode of care groups
  • Joined the AMA in calling for better electronic health record interoperability
  • Provided direct input on patient relationship categories
  • Supported the Alliance's editorial on MACRA's flaws, published by The Hill
  • Commented on 2018 QPP Final Rule