​​MACRA University

Pathway 1.  Enroll in an Advanced Alternative Payment Model (APM) if available. Examples of Advanced APMs include:

  • Medicare Shared Savings Accountable Care Organization - Track 2
  • Medicare Shared Savings Accountable Care Organization - Track 3
  • Primary Care Plus Model
  • Next Generation Accountable Care Organization


In order to qualify providers must have a minimum amount of revenue or patient volume attributed to the APM.  Providers that qualify may earn a 5% bonus and are not subjected to the potential payment adjustments or public reporting of their MIPS scores.

Pathway 3.  Report a minimum of one quality measure, a minimum of improvement activity, and a minimum of 90 days of advancing care information under MIPS.  This will make providers potentially eligible for a "moderate" positive payment adjustment.  However, it is less likely to result in the full 4% adjustment

Pathway 4.  Report at least one measure or one improvement activity or 90 days of advancing care information.  This will result in no payment adjustment, but not reporting at or above this minimal reporting level will result in a the full 4% negative payment adjustment.

Pathway 2.  Report data under the full MIPS program for 90-365 days.  This pathway makes the eligible clinician or group eligible for up a 4% upward payment adjustment under MIPS.  However, all components of the MIPS, with the exception of utilization (cost) will be used to determine the MIPS score.  

For more information please see the following article that was published in the Journal of AHIMA: MACRA Strategies for 2017: Advantages and Disadvantages of Four Options