The (SGR) Fix Is In: How MACRA Short-Circuited Incentives for Joining Two-Sided Models

Tim Gronniger, Scott Heiser, Rahul Rajkumar, Joe Lucas, and Misha Segal explore the history and evolution of Medicare payment reform and growth in alternative payment models (APMs), including the Medicare Shared Savings Program (MSSP). The authors also highlight advanced APMs (A-APMs), such as risk-bearing accountable care organizations, and the policy decisions impacting incentives that have limited provider adoption of these risk models. The authors provide potential federal policy solutions to improve participation and success in these risk-bearing models and illustrate what the future could hold for A-APMs if the correct steps are taken by Congress.

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