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The Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) repealed the Sustainable Growth Rate. It enabled the Centers for Medicare & Medicaid Services (CMS) to create a new program that transforms how providers are paid under Medicare.

In June 2016, CMS released the proposed rule related to MACRA, which established the Quality Payment Program (QPP). The QPP is made up of three components; Merit-based Incentive Payment System (MIPS), MIPS Value Pathways (MVPs), and Alternative Payment Models (APMs).