2026 Signature Series Congressional Briefing

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., Harvard Medical School, Leonard D. Schaeffer Professor of Health Care Policy
• Kristen O’Brien, JD, Principal, McDermott+

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.