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.


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