MACRA & The Quality Payment Program (QPP)

The Medicare Access and Chip Reauthorization Act of 2015 (MACRA) is bipartisan legislation established to reform Medicare payments for clinicians through the Quality Payment Program (QPP).  The Department of Health and Human Services along with the Centers for Medicare and Medicaid have been engaged in the process of drafting rules based on the legislation since the law passed. The new QPP is designed to improve health outcomes while lowering the cost of healthcare. It is an integral part of the transition to value and quality.

MACRA repeals the old Sustainable Growth Rate (SGR) formula for determining Medicare payments, and combines existing quality reporting programs into one new system.  Eligible clinicians can select to participate in one of two tracks in the Quality Payment Program, the Merit-based Incentive Payment System (MIPS) or Advanced Alternative Payment Models (APMs). These changes will dramatically affect clinicians, hospitals, and healthcare organizations in different ways.

For national resources available through the American Hospital Association click here.

In our state, the South Carolina Office of Rural Health (ORH), the Carolinas Center for Medical Excellence (CCME), SCHA and others are providing tools, resources, and programs to assist hospitals, physician practices, and clinicians prepare for MACRA.
Below is a guide to state resources that are available depending on your needs.

Are you currently or interested in becoming a Patient-Centered Medical Home?

The SC Office of Rural Health is leading the efforts of the SC PCMH Alliance in supporting MACRA education, training, and resources.

For more information, contact:
Michelle Stanek

Are you a rural hospital, small rural practice (fewer than 15 clincians), or a Rural Health Clinic (RHC)?

The SC Office of Rural Health provides direct technical assistance and coordinates and conducts learning opportunities and resources on MACRA and the Quality Payment Program (QPP). SCORH is funded through the Georgia Medical Care Foundation by CMS to support SC small practices (<15 clincians) to navigate the new lad and program. MACRA currently exempts RHCs, FQHCs and low-volume Medicare providers; however, we encourage all providers to begin educating themselves about MACRA, particularly the Merit-based Incentive Payment System (MIPS) requirements, in anticipation of the continued move towards value-based payments. ORH will also provide linkage and support related medical home development and other practice transformation efforts and pay-for-value initiatives in SC.  Click here for webinar-based learning opportunities.

For more information, contact:
Michele Stanek

Are you a large hospital or hospital system or a practice with more than 15 clinicians?

The Carolinas Center for Medical Excellence is one of the 14 Medicare-funded Quality Innovation Network-Quality Improvement Organizations (QIN-QIO) and is leading efforts to support the Quality Payment Program (QPP) instituted by MACRA. CCME offers direct technical assistance, educational resources for clinicians, and additional learning opportunities.

For more information, contact:
Jennifer Boyd
1.800.922.3089 ext. 7534

Upcoming Educational Opportunities

Alliant Quality and SC Office of Rural Health (SCORH) are working together to help small practices in South Carolina with 15 or fewer clinicians under one tax ID number to understand and participate in the Quality Payment Program (QPP)/MACRA/MIPS. The SCORH Team is  also available to provide direct technical assistance at no cost to help Merit-based Incentive Payment System (MIPS) eligible clinicians participate in the Quality Payment Program.

To assist in preparing for MIPS participation, they will be having regular webinars and office hours for eligible practices. Office hours provide callers with the opportunity to discuss individual concerns and get answers to questions specific to their practice. During the webinars, we will provide an overview of important information regarding the MIPS program followed by Q&A.  For more information or to register for the Spring 2018 webinars, click here.

 The Team will also hold two in-person workshops in the Spring of 2018, one on March 16 in Columbia and another on March 21 in Florence. Registration and additional information are available here.

They are also asking for practices looking for assistance with their participation in MIPS to complete a brief survey, which is available here.  

We will use the survey information to determine how we can best support your practice.  




CMS Quality Payment Program
CMS Path to Value Presentation
5 Things to Take Away from the MACRA Final Rule
No-Cost Technical Assistance for Small Practices Flyer
AHA MACRA Issue Brief
SCORH and Alliant Quality Webinars for Small and Rural Practices


Documents and Resources