Practice Management: ACOG Is Here to Help You Get Ready for MACRA

After more than a decade of pushing for its repeal, physicians finally saw the end of the Sustainable Growth Rate (SGR). SGR was a flawed mathematical formula written into law that repeatedly targeted physicians with double-digit pay cuts in Medicare. ACOG worked closely with the American Medical Association (AMA), the Federation of Medicine, and US Congress in getting the Medicare Access and CHIP Reauthorization Act (MACRA), the replacement for SGR, passed into law. Congress wrote the law to ensure that physicians would be integrally involved in determining the specifics of implementation. This aspect of the legislation is an opportunity but also a challenge. 

In April, the Centers for Medicare and Medicaid Services (CMS) issued a large set of proposed implementation rules, with a proposed starting date of January 1, 2017.  We believe that start date will be delayed, and we are trying to ensure that practices will not need to incorporate changes before July 1, 2017.  However, no matter what happens in November, MACRA is our new reality. ACOG is here to help you prepare your practice for these changes.

Surveys show that fewer than 25 percent of physicians are even aware that this new change is upon us.  ACOG has a responsibility to our Fellows: We want to educate you on MACRA and enable you to make wise choices as you participate in the program. We also want to work with you and CMS to help guarantee proper implementation of the law. CMS will not release their final rule until November 2016, so there may be some variations in the program requirements and the proposed rules.

ACOG is here to help: 

  1. Get ready. ACOG estimates that 50 percent of ob-gyns will not have to participate in MACRA.  Educate yourself on what changes, if any, you will need to make to succeed and thrive under MACRA for your Medicare patients.  
  2. Learn about the new payment system. MACRA intends to incentivize the delivery of value-based care. It will incorporate quality and resource use measures, certified electronic health record use, and quality improvement activities into a formula that impacts payment. There’s a lot to learn, so start now by visiting
  3. Advocate for needed changes. MACRA is far from perfect. Many changes need to be made to make it work for you.  When we ask for your help to improve MACRA, please take action.  
  4. Work together. We will help each other rise to this new challenge. We all need to embrace this change and work for the best possible outcome.

ACOG is already working with CMS and Congress to ensure that the final requirements don’t impinge on our ability to deliver high-quality care. We are advocating for changes that will help ob-gyns who have a low volume of Medicare patients. We are also encouraging improvements be made to simplify implementation and ensure this new payment system is one we can all trust.

Over the coming months, ACOG will provide you with important resources to help you efficiently transition to this new program. Resources will include a dedicated webpage, ready-to-use PowerPoints, payment reform modules during coding workshops, presentations at ACOG’s Congressional Leadership Conference and Annual Clinical and Scientific Meeting, on-demand webinars, and a weekly call-in office hours where you can talk to ACOG experts about your questions.

ACOG is committed to helping you through this payment transition by pushing for the best implementation we can get. We will help make this transition as easy and successful as possible for you. We will use every tool we have to make sure you understand this complicated system and can continue to make right choices for your practice and patients.

Please send your questions and concerns to We are here to help you, and we'll be with you every step of the way.

American College of Obstetricians and Gynecologists
409 12th Street SW, Washington, DC  20024-2188
Mailing Address: PO Box 96920, Washington, DC 20024-9998