2026 Signature Series Congressional Briefing

September 1, 2026

12:00 pm-

1:30 pm

MACRA: Perspectives on What Worked in the 2015 Reform, What’s Missing, and Why It Matters Today

The Medicare Access and CHIP Reauthorization Act (MACRA) was enacted in 2015, repealing the Sustainable Growth Rate formula and establishing a new framework for Medicare physician payment. As Congress revisits the Medicare Physician Fee Schedule and MACRA’s value-based incentives, this briefing will consider the law’s original objectives, its implementation, and how the physician payment landscape has evolved since its passage.

As the final event in the Alliance’s Signature Series on Health Care Payment, the briefing will examine MACRA as a case study in bipartisan payment reform. Expert panelists will trace the major milestones that shaped Medicare physician payment, explain how rates are set, and explore what MACRA changed. At the heart of the program, former congressional staff who helped develop and implement the law will take attendees inside “the room where it happened” to discuss what Congress sought to accomplish, what happened after implementation, and what they have learned since. Drawing on recent data and analysis, including findings from MedPAC, the program will also examine where physician payment stands today.

Together, these perspectives will provide congressional staff and the broader public with historical context and a framework for understanding ongoing Medicare physician payment discussions.

By the end of this briefing, attendees will be able to:

Trace the history of Medicare physician payment and the changes established by MACRA.
Identify MACRA’s original policy goals and the trade-offs made during negotiations.
Understand how Medicare physician payment rates are determined, including the roles of relative value units, the conversion factor, budget neutrality, and the Relative Value Scale Update Committee (RUC).
Review recent physician payment data and trends and identify considerations relevant to ongoing congressional deliberations.

Speakers

Michael Baker, MS, MA, Director, Health Care Policy, American Action Forum (moderator)
Brett Baker, Partner, The Nickles Group
Michael Chernew, Ph.D., Leonard D. Schaeffer Professor of Health Care Policy, Department of Health Care Policy, Harvard Medical School; Director, Healthcare Markets and Regulation Lab, Harvard Medical School
Kristen O’Brien, JD, Partner, Holland & Knight

Other speakers to be announced!

This widely attended educational event is free and open to the public. The Alliance gratefully acknowledges the sponsors of the Signature Series on Health Care Payment, whose support makes this educational programming possible. View the complete list of Signature Series sponsors.

Speakers

Michael Baker, M.S., M.A.

Director, Health Care Policy, American Action Forum

Michael leads AAF’s health care research and analysis portfolio, including prescription drug pricing policy, Medicare and Medicaid payment rules, the Food and Drug Administration, and employer-sponsored insurance markets. His research and analysis have appeared in numerous publications. Prior to joining AAF, Michael worked in both the public and private sectors on a broad array of health and human services policy. He has provided in-house and multi-client health policy leadership in the private sector, including on policy development, regulatory affairs, and strategic capital planning, for hospitals, payers, investment firms, and other stakeholders. Michael also worked at the Department of Health and Human Services on issues related to drug pricing and pharmaceutical manufacturing, public health, competition and transparency, and innovation policy. His purview has also included health IT interoperability and data exchange, HIPAA, and public health informatics. Michael holds a master’s degree in biohazardous threat agents and emerging infectious diseases from Georgetown University, a master’s degree in economics from American University, and a bachelor’s degree in biology from the University of Toledo.

Brett Baker

Partner, The Nickles Group

Brett Baker is a Partner at The Nickles Group. His extensive legislative and policy experience have earned him the respect and trust of policymakers across the political spectrum that helps clients achieve their goals. He spent over a decade on Capitol Hill working on many of the significant Medicare bills that passed Congress during that time. He has shaped health care policies that have touched every sector of the health care industry. Brett was integral in the development of legislation that provided relief to physicians from Medicare Sustainable Growth Rate (SGR) formula payment reductions, including the transformative Medicare Access and CHIP Reauthorization Act (MACRA) enacted in 2015. He also played a leading role in shaping the prescription pricing policy debate and COVID-19 relief laws enacted during the first year of the pandemic. Brett worked for the Senate Finance Committee where he held key health staff positions under Chairman Orrin Hatch (R-UT), Chairman Chuck Grassley (R-IA), and Ranking Member Mike Crapo (R-ID). Prior to his service in the Senate, Brett was a professional staff member for the House Ways and Means Committee under Chairman Dave Camp (R-MI) and Paul Ryan (R-WI), where he focused on physician payment policy and other Medicare Part B issues. Brett began his career at the American College of Physicians in Washington, D.C. He has a Bachelor of Science degree from the Pennsylvania State University.

Michael Chernew, Ph.D.

Leonard D. Schaeffer Professor of Health Care Policy, Department of Health Care Policy, Harvard Medical School; Director, Healthcare Markets and Regulation Lab, Harvard Medical School

Michael Chernew, PhD, is the Leonard D. Schaeffer Professor of Health Care Policy and Director of the Healthcare Markets and Regulation Lab at Harvard Medical School. His research focuses on improving the healthcare system through improvements to benefit designs, payment models, and regulation of both private and public health care markets, including the Medicare Advantage program. Michael served as Chair of the Medicare Payment Advisory Commission (MedPAC) and vice chair of the Massachusetts Health Connector Board. He has served on several advisory panels for CMS and is a member of the Congressional Budget Office’s Panel of Health Advisors. Michael holds a PhD in economics from Stanford University and has received multiple awards for his work in healthcare policy.

Kristen O’Brien, J.D.

Partner, Holland & Knight

Kristen's work focuses on implementing new laws through the rulemaking process, as well as working with relevant agency officials to develop and improve agency guidance. Kristen recently served as Principal of the Health Industry Policy and Regulatory Practice Group at a law and lobbying firm where she provided representation for hospital systems, physician practices, medical device companies, digital health companies and trade associations. She has extensive experience in providing analysis and counsel related to government healthcare payment programs under Medicare and Medicaid. She also has extensive knowledge of navigating the Centers for Medicare & Medicaid Services (CMS), the Office of the National Coordinator for Health Information Technology (ONC) and others. Previously, Kristen provided legislative and regulatory legal analysis as a senior attorney for the American Medical Association.

Event Series

This event is part of the

Signature Series 2026

series.

Signature Series 2026

Health Care Payment

In 2026, the Alliance for Health Policy will mark the 10th year of its flagship annual Signature Series by examining one of the most foundational and least understood drivers of the health care system: how health care is paid for.

Learn More about the Series

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