What are the two MACRA tracks, and who do they apply to?

• A. MIPS for most clinicians and Alternative Payment Models (APMs) for those in eligible risk-bearing arrangements.
• B. MIPS for hospitals and APMs for patients.
• C. APMs apply only to hospital administrators.
• D. APMs require exclusive capitation with no risk sharing.

Answer: (A)

MACRA splits Medicare payment adjustments into two paths: MIPS and APMs. The MIPS path is designed for the vast majority of clinicians and combines several prior quality programs into one performance-based track that determines payment adjustments based on how clinicians perform across defined measures. The Alternative Payment Models path targets those who participate in eligible models that carry financial risk for Medicare spending and quality outcomes; clinicians in these risk-bearing models can follow the APM track and may receive different incentive structures, often with potential exemptions from MIPS. This is why the option stating MIPS for most clinicians and APMs for those in eligible risk-bearing arrangements is the best fit. The other statements mischaracterize who the tracks apply to, such as suggesting hospitals, patients, or non-risk-capitated arrangements.