MIPS/APMs The Medicare Access and CHIP Reauthorization Act (MACRA) of 2015, passed on April 14, 2016, repealed the flawed sustainable growth rate formula and set in motion a new future for Medicare payments including predictable, positive payment updates, as well as two new, separate pathways to value-based reimbursement: Merit-based Incentive Payment System (MIPS) or Advanced Alternative Payment Models. Once the law was passed, CMS implemented details on MIPS reporting requirements and APM participation through rulemaking, which is updated annually. CMS calls MACRA the Quality Payment Program (QPP). MIPS A new, all-encompassing federal quality reporting program that potentially adjusts Medicare payments based on performance on quality, cost, EHR, and improvement activity metrics. APMs Under MACRA, practices may receive a financial incentive and exemption from MIPS by participating in a subset of alternative payment models (APMs).