Steven Lash, noted healthcare strategic advisor said “As a result of MACRA, from July 2015 through 2019, physicians will be guaranteed a 0.5% update. From January 2020 through 2025, the law includes a zero percent update; but, some providers will get annual bonuses and others will get annual awards or penalties.”

1. Steven lash

2. Physician Payment in the Post-SGR Era
• Legislation called the Medicare Access and CHIP
Reauthorization Act (MACRA) passed earlier this year
(2015) has already made fundamental changes to the way
physicians are reimbursed by Medicare and will continue to
reshape physician reimbursement to 2026 and beyond.
The high-stakes legislative battles of the past several years
over the “doc fix” and annual updates is over as a new
physician payment system has been defined
• Steven Lash, noted healthcare strategic advisor said “As a
result of MACRA, from July 2015 through 2019, physicians
will be guaranteed a 0.5% update. From January 2020
through 2025, the law includes a zero percent update; but,
some providers will get annual bonuses and others will get
annual awards or penalties.”

3. Steven Lash continued his comments adding that
there are 2 new questions that will need to be
answered.
• How can physicians avoid the 4-9% cuts to
reimbursement which could be imposed
beginning in 2019 under Medicare’s new pay-
for-performance system?
• How can physicians get exempted from the
new pay-for-performance system altogether
and lock-in annual bonuses of 5% per year
starting in 2019?

4. • The legislation provides the broad answer to these
questions: Physicians must begin to participate in
“alternative” value-based payment models. What
those models will be is substantially to be determined.
• Already, MACRA has replaced the 20% cut to physician
reimbursement threatened by the SGR (Sustainable
Growth Rate) with more-or-less status quo updates
annually beginning in 2015 and running through 2019
to be followed by an update freeze through 2025.
• Between now and 2019, several new and existing
entities have been tasked with answering the two
questions above: what will the new pay-for-
performance system look like and how can physicians
opt out of it and into a bonus-based alternative?

5. Thank You
Steven Lash