What did MACRA lead to?

• A. Reduced accountability for payers
• B. Integration horizontally and vertically to manage cost and quality, with providers more accountable to payers for quality and cost
• C. Expansion of fee-for-service without quality metrics
• D. Elimination of APMs

Answer: (B)

MACRA moves Medicare reimbursement from paying for volume to paying for value. It established the Quality Payment Program, with two pathways: MIPS, which ties payments to performance on quality, cost, improvement activities, and interoperability, and Advanced APMs, which reward clinicians for taking on risk in alternative payment models. This structure makes providers more accountable to payers for both quality and total cost of care, and it encourages greater coordination and integration across settings to manage costs and improve outcomes. The other options don’t fit because MACRA increases accountability, adds quality metrics to reimbursement, and actually expands APMs rather than eliminating them.