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The Medicare Access and CHIP Reauthorization Act of 2015, which is known as MACRA, is an act that impacts doctors, hospitals, and Medicare beneficiaries alike. This article will not only describe what MACRA is but also help you understand how it is beneficial to beneficiaries.

What Exactly is MACRA?

Before we go into the benefits of MACRA, you need to know what MACRA is exactly. MACRA stands for The Medicare Access and CHIP Reauthorization Act of 2015. This legislation was signed into law on 16th April 2015. It came to solve many issues. However, what MACRA is famous for is creating the Quality Payment Program for healthcare provider reimbursement. It was also designed to regulate Medicare costs.

Benefits of MACRA To Beneficiaries and How MACRA Affects Beneficiaries

Although there is a consensus that MACRA benefits doctors, physicians, and hospitals, it affects and benefits beneficiaries too. Here, we will focus solely on how MACRA affects beneficiaries or how MACRA is beneficial to beneficiaries.

1. Assures Better Services for Beneficiaries

One of the significant benefits of MACRA to beneficiaries is that it gives every beneficiary of Medicare a relative assurance of quality service. One reason for this is that with MACRA, Medicare now rewards clinicians and doctors for the value offered to beneficiaries rather than rewarding them for the number of beneficiaries they cater for. In light of this, hospitals, doctors, or clinicians will strive hard to provide adequate care for all beneficiaries under them.

The way this works is that MACRA created the Merit-Based Incentive Payment System and the Advanced, Alternative Payment Models to replace the Sustainable Growth Rate Formula. These systems and models measure these doctors' or clinicians' performance under various categories and then reward the performing professionals. Note that Medicare-approved providers can decide to choose between the Merit-Based Payment System and the Advanced Alternative Payment Models depending on their preferences.

2. Better Security Through Medicare Cards

Another benefit of MACRA to beneficiaries is that MACRA has made it compulsory for all Centers for Medicare & Medicaid Services (CMS) to update their cards. These updates will help improve security. The way these new update works is that instead of using Social Security Numbers on Medicare cards, CMS will now use Medicare Beneficiary Identifiers instead. This change will help to eliminate situations of fraud and also prevent identity thefts. Besides, the Medicare Beneficiary Identifier is randomly generated, and it combines both numbers and letters. All beneficiaries get a unique one that is used to identify them.

3. Updates for Medicare Supplement Plans

Another way MACRA affects beneficiaries is through the updates of Medicare supplement plans. First, the Medigap Plans C and F were discontinued in 2020. These plans were the only plans that covered the Medicare Part B deductible. And for this, they had to be discontinued. Moreover, since Congress voted to eliminate the 'first dollar coverage' that Medigap Plans C and F have, they had to be discontinued. However, if you were eligible for Medicare before 2020, you can still enroll for these plans after the 1st January 2020 deadline.

Furthermore, Medicare Beneficiaries also saw some changes to the Medigap Plans D and G. The Plans D and G used to be non-guaranteed issue plans. However, things have now changed, and they are now guaranteed issue plans for all the newly eligible enrollees of Medicare. This means that the Plans D and G plans will now be guaranteed issue plans for people eligible for Medicare from 1st January 2020.

The good thing about the guaranteed issue is that all Medicare-eligible individuals can enroll in guaranteed issue Medigap plans even when their Medigap enrollment period isn’t open.

My Final Word

Although most of the regulations and changes of MACRA affects healthcare providers, doctors, clinicians more, MACRA affects beneficiaries too. Notably, the new regulation helps to ensure that all beneficiaries have access to good healthcare services. Not only that, but the use of Medicare Beneficiary Identifiers instead of Social Security Numbers also helps security-wise. It helps to eliminate identity theft and reduce fraud.

Also, MACRA does not allow Medigap plans to cover the Part B deductible. This means that you will not be able to buy the Plan C or Plan F anymore. However, remember that you can still purchase these plans if you have been eligible for Medicare on or before 31st December 2019. In conclusion, MACRA has some positive effects on beneficiaries.


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