MACRA Excludes Most Medicaid Patient-Centered Medical Homes As Alternate Payment Model

Most patient-centered medical homes (PCMHs) serving Medicaid beneficiaries will not count as advanced alternative payment models (APMS) under the new Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) rules for fee-for-service physician payment. Under MACRA, Medicare physicians must participate in the CMS Quality Payment Program (QPP). The program has two value-based options: the Merit-Based Incentive Payment System (MIPS) or Advanced Alternative Payment Models (Advanced APMs). Professionals can pick one of the two options. MIPS does not apply to hospitals or facilities.

MIPS requires eligible professionals to submit quality of care reports to avoid a . . .