8 Aug 2022


Medicare Access and CHIP Reauthorization Act of 2015

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Academic level: College

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Healthcare system in the United States of America has undergone different revolution from the management to the introduction of healthcare reforms and provisions which have seen the great impact in this sector. The introduction of the Obamacare made several changes in the health sector. However, more changes are yet to be witnessed with the implementation of the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) which was recently introduced. 

MACRA is a new payment system of the healthcare workers in America, hence to some extent; it is a revision of the budget balance act of the year 1997. MACRA fills in the way the payment of the medical doctors is done, the funding gap as wells as extending the insurance programs of the children’s. Also within its regulation is the discussion on the incentives for the Information technology use by the physicians and other care providers (Access, M. CHIP Reauthorization Act of 2015). 

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A good number of reactions has been aired some in support while others object the use of MACRA. Mostly, a good number of physicians seem to be at log head with this act. Moreover, it is anticipated that its implementation may raise management challenges in healthcare sectors. In this paper, there are critical issues concerning the impact of the MACRA act in the hospital and the entire health sector management which are broadly discussed. 

The role of the management topic in the health care organizations 

One of the challenges which the implantation of MACRA may impose in the healthcare sector is its management in the healthcare organization. This act brings about the change introduction in healthcare sector which calls upon the managers to play critical role in managing. The management must play some critical role to ensure that this Act is properly coherent with the healthcare organization structure. 

Firstly, the management of the Healthcare organization will play great role in managing the change from the old system to MACRA. The organization management, therefore, is task with a role of educating the staff on how to use the new payment system and orient them on how their role has changed towards the usage of payment models under the MACRA such as the Incentive Payment System and the Alternative Payment Model (Keehan et al., 2015). 

Alternatively, the management has the role in ensuring that the entire organization structure and management is congruent with the MACRA. For this reason, the management has the great role to play for safe implementation of this act in their organizations. They have a role to play to ensure that the budget allocated for the implementation of the MACRA act is fully utilized without shortages. Also, it is their role to help the government ensure that the act is full functions in the entire organization. 

Lastly, it is the role of the organization management to ensure that the queries about this act are properly handled to perpetuate its need and awareness in the organizations. They have a role to gather its feedback whether positive or negative from the staff. The feedback is very critical since it can be used by the federal government to ensure that any quarry is addressed properly or amended in case the need to do so. 

The impact of the topic selected by the HCO management processes 

MACRA has a great impact on the management process of the healthcare organization. The impact brought about by this Act implementation can either be positive or negative depending on the perception of the users and many other issues. 

Firstly, the MACRA has a great impact in the department of human resources in the healthcare organization. The act directly affects the medical doctors hence the department faces a direct challenge of change management orientation on the staff payment issues and orientation of the new methods. For instance, there is a change on an issue such as the advance payment under the quality payment programs which are all under MACRA. These are issues which the hospital uses to handle without quarries. However, the change needs integration of orientation strategies to ensure that the staff is well placed. 

Alternatively, under the new Act, there is a difference in reporting issues for doctors. For instance, the clinicians will have to choose how they report their day to day practices, which have to reflect in the Electronic medical records technology. This means that the organization has to readjust their EMR system to accommodative such changes. 

Alternatively, the MACRA implementation will have the effect on the management of the organization. For instance, the finance department will have to readjust their financial strategies to accommodate this change. The Congress passed this act. However, the there was no amount money put aside for the hospitals and the care sector which could be used to implement this program. The implementation package will have to come with the cost for instance training cost for the change, readjustment, and others. This brings instability to the HCO. 

Lastly, MACRA may help the management of the HCO improve quality care in the hospital. The change in the payment system under MACRA needs the doctor or clinicians to work extra and attend to the number of patients and services required in their reports in a day; this minimized laziness and luxury during the work. This will enhance the ease of supervision by the HCO administration since; the healthcare profession has the target to attain for the quality payment, rewards, and motivation under the new system. 

How the management topic impacts the cost of healthcare, staffing capability, and other health care activities. 

There is the mixed anticipation of the outcome of the MACRA implementation in the USA healthcare system. Firstly, the there is an anticipation of the less payment to the clinicians when MACRA is implemented, and this may reduce the healthcare cost. For instance, under the Merit Based Incentives Payment System, there will both risk and benefits. However, the risk is more pronounced than the benefits. The merits will base on issues such as clinician quality, resources utilization, improvements and many others. These merits have benefits and penalties, where benefits will be rewards from a registered improvement and negative improvement deducted, most of the clinicians may not hit target hence deduction will be more prominent. This amount can be used to expand health sector and reduce its cost. Alternatively, the cost of care may increase since, in the USA, over half a million doctors are under contract paid by the hospitals. It means that the hospitals may defray the cost of other activities in the hospital to comply with the policy. This may increase the cost and the general care services in the hospital. 

Explain how the management topic is related to the government regulatory environmen

MACRA has an impact on the doctor’s remuneration departments and regulations. Its introduction will see a huge shift since; the payment is in the MACRA system is value based and is anchored by their performance in the hospital. 

Describe the relationship, if any, your topic has to special interest groups and other health care organizations such as JCAHO, etc. 

The introduction of MCRA has been received by the mixed reaction from different organizations, group, and institutions. The first group to complain about this issue is the union of doctors. They feel that MACRA is an additional burden on their back to the already unsolved issues they have. They have a feeling that cooperating with the new regulations may be difficult due to drastic change required from the old system. For instance, when it comes to value-based reimbursement, it seems to be adding more pressure on them. The reporting system is almost doubled, and hence more pressure has been added to individual doctors without removing the services fee which was the requirement in the old system. 

Another body which has complained about MACRA is the Electronic Health Records machine vendors. To them, the MACRA has a possibility of destructing the growing invention in the sector. The organizations will now readjust to meet the government requirements since EHR is a very paramount tool in the MACRA system (Access, 2015). They will have to shift their innovative work and activities to conform to the government regulations and standards. This according to them is a very big demerit. The Joint Commission on the Accreditation of Healthcare Organizations (JCAHO) supports the MACRA and in their statement released on their website; the commission certified that MACRA application conforms to their mission which is to make healthcare in America better. 

Describe any strategies necessary to implement this topic into the HCO management process in health care organizations today 

Many methods can be used to implement the MACRA in today’s healthcare system. For instance, piloting strategy is one such implementation process; however, the three C’s implementations strategy seems to be the best. The first C is the clarification of the MACRA regulations and requirements to the staff. This is done with an aim to make the Act clearer to the staff and enhance their understanding to embrace the change. The second C is to communicate the MACRA implementation strategies to all the staff that is going to be directly or indirectly affected by its implementations (Fullerton & McWatters, 2010). The last C is to cascade the MACRA strategy into the organizations. In this case, find the agents of changes and approach those who are at top ranks and have the capability of interfering with the program and lure them to your side. 

Include any impact the management topic would have on health care policy making today 

MACRA has a capability of making a great impact on the use of technology policy to provide health care for the citizens. The trend in care is shifting from the manual care to the digital care with the introduction of the EMR and other machines. One policy which, may be affected by the introduction of MACRA is the digitalization of the care. The hospitals must invest in the technology which has the capability to allow the hospital to connect and integrate data from the MACRA reporting. This technology musty also gave the capability to review the staff performance and care shifts. Lastly, they have to also invest in the decision making care tools which will have an impact on the transforming the physicians point of care information. 


Different reactions have received the introduction of MACRA. Many complaints have been aired by different parties affected as others praising the system. However, for the Act to fully function well, it calls upon the care institutions management to be very vigilant. 


Access, M. (2015). CHIP Reauthorization Act of 2015. HR 2. In 114th Congress

Access, M. CHIP Reauthorization Act of 2015 (MACRA). (Pub. L. No. 114–10, enacted April 16, 2015). 

Fullerton, R. R., & McWatters, C. S. (2010). The production performance benefits from JIT implementation. Journal of operations management , 19 (1), 81-96. 

Keehan, S. P., Cuckler, G. A., Sisko, A. M., Madison, A. J., Smith, S. D., Stone, D. A., ... & Lizonitz, J. M. (2015). National health expenditure projections, 2014–24: spending growth faster than recent trends. Health Affairs , 34 (8), 1407-1417. 

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StudyBounty. (2023, September 15). Medicare Access and CHIP Reauthorization Act of 2015.


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