Value-Based Payment in Ambulatory Anesthesia: MACRA, MIPS, and More

Douglas G Merrill

doi:10.1016/j.anclin.2019.01.011

Value-Based Payment in Ambulatory Anesthesia: MACRA, MIPS, and More

Anesthesiol Clin. 2019 Jun;37(2):373-388. doi: 10.1016/j.anclin.2019.01.011.

Author

Douglas G Merrill¹

Affiliation

¹ Merrill Healthcare, Reno, NV 89511, USA. Electronic address: dougmd53@gmail.com.

PMID: 31047136
DOI: 10.1016/j.anclin.2019.01.011

Abstract

Congress passed the Medicare Access and Chip Reauthorization Act of 2015 to replace the flawed sustainable growth rate system and it consolidates all pay-for-performance programs. These programs are intended to reduce health care costs but do not address the lack of funding for the social networks that (in all other developed countries) support better health and lower health care use and cost. These programs require reporting by providers about performance on quality, cost, and other metrics, leading to bonuses for those who exceed Centers for Medicare & Medicaid Services-determined metrics and financial penalties for those who do not.

Keywords: Anesthesiology; Billing; CMS; MACRA; MIPS; Pay for performance; Payment.

Publication types

Review

MeSH terms

Ambulatory Surgical Procedures / economics*
Ambulatory Surgical Procedures / legislation & jurisprudence
Anesthesia / economics*
Anesthesiology / legislation & jurisprudence
Centers for Medicare and Medicaid Services, U.S.
Humans
Medicare
Prospective Payment System
United States