NCQA’s Take on MACRA: A Vision for the Future of Medicare Value-Based Payment

October 16, 2015 · NCQA

Following extensive study and analysis of the Medicare Access & CHIP Reauthorization Act (MACRA), NCQA’s Public Policy team has composed a white paper on the team’s vision for the future of Medicare Value-Based Payment.

Here’s an excerpt:

Medicare will soon begin paying physicians and other clinicians for the value rather than volume of care they provide. This transition is advancing through the Medicare Access & CHIP Reauthorization ACT (MACRA), a law recently enacted with broad bipartisan and multi-stakeholder support. MACRA includes a Merit-Based Incentive Payment System (MIPS) that will adjust fee-for-service (FFS) payment based on performance. MACRA also encourages clinicians to develop and participate in Alternative Payment Models (APMs) that move toward greater compensation for value instead of volume. Current quality measurement abilities can help to start this important advancement. However, the optimal future state of measurement to support performance-based clinician pay requires more work that must begin now. This paper suggests for discussion potential principles for achieving that optimal future state:

  • PRINCIPLE A: Every Medicare enrollee needs a dedicated and well-organized primary care team. 
  • PRINCIPLE B: Measurement must be specified appropriately for each different unit of accountability. 
  • PRINCIPLE C: Measurement should support rapid improvement and clinical decision making.   
  • PRINCIPLE D: A core set of measures will let all stakeholders make comparisons across programs. 
  • PRINCIPLE E: Quality measure results should be easy for consumers and payers to get and use.


You may read the entire paper at:

NCQA also seeks your take on these ideas. To the right of the full paper, you’ll find an opportunity to click and share your thoughts on these ideas with the Public Policy team. We do hope you’ll take advantage of this opportunity.

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