MACRA: The Burden of Proof

MACRA:  The Burden of Proof

by Carol Monaco

The Centers for Medicare and Medicaid Services has released a 2,398-page final rule implementing what is likely the most complex clinician payment program in Medicare’s history, known as the Quality Payment Program, born out of the Medicare Access & CHIP Reauthorization Act of 2015 or MACRA.

As MACRA is implemented, the hope of financial stability and administrative relief for physicians treating Medicare patients may be short-lived.

If past is prologue, physicians should prepare themselves for years of payment system revisions, modifications, and amendments that go well beyond 2019 when the Quality Payment Program’s first payment adjustments go into effect.


Carol Monaco, an independent writer who is an expert in health policy and regulatory issues, produced an in-depth analysis of the CMS proposed rule to implement MACRA and the likely implications on private physician practice.

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