September 2016

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Congress’s enactment of the Medicare Access and CHIP Reauthorization Act (MACRA) last year repealed Medicare’s sustainable growth rate (SGR) in favor of a new Merit-based Incentive Payment System (MIPS) intended to increase quality of care across the United States. The law was designed to shift how health care providers are paid from a volume-based payment system to a value-based system. While well-intentioned, this push raises several concerns especially as states begin to also adopt and promote similar policies with their Medicaid programs. Most notably that providers with higher quality scores tend to also have higher disparities in care among racial and ethnic minorities and…