Evidence map›Paper›PMID 40312801›Full record

ArticleHealth services research2025

Navigating New Waters: How Did MACRA 2015 Transform Practices Among Medicare Part B Physicians?

Mahmoud Manouchehri Amoli, Bassam Dahman

Abstract read
In one paragraph

Article in Health services research, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

2 authors.

Mahmoud Manouchehri AmoliDepartment of Health Policy, Virginia Commonwealth University, Richmond, Virginia, USA.ORCID https://orcid.org/0000-0002-4112-4240
Bassam DahmanDepartment of Health Policy, Virginia Commonwealth University, Richmond, Virginia, USA.ORCID https://orcid.org/0000-0001-7209-5369

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivesTo assess whether physicians participating in the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) exhibit different billing behaviors and practice patterns compared to non-participating physicians after MACRA implementation. STUDY SETTING AND

designA quasi-experimental staggered difference-in-difference design was used to compare pre-and post-MACRA changes among participants and non-participants from 2013 to 2021. Primary outcomes included annual submitted charges, annual Medicare payments, and charge-to-payment ratios. Secondary outcomes were average charges and payments per beneficiary, total services, and the number of beneficiaries served. DATA SOURCES AND ANALYTIC SAMPLE: The study analyzed secondary data from Centers for Medicare & Medicaid Services (CMS) Medicare Fee-For-Service Provider Utilization and Payment Data (2013-2021), providing outcome measures and control variables; Quality Payment Program (QPP) Experience Reports (2017-2021), the National Plan and Provider Enumeration System, and Medicare Geographic Variation Public Use File. The analytic sample included 4,924,118 physician-year observations (749,129 unique physicians), with 50.2% participating in MACRA. PRINCIPAL

findingsMACRA participation was associated with significant annual increases of $36,677 (95% CI: 28,918, 44,436) in total submitted charges and $9164 (95% CI: 7288, 11,041) in total Medicare payments compared to non-participation. However, these increases appeared primarily driven by a substantial increase in the total number of Medicare beneficiaries served per physician (29.77 beneficiaries; 95% CI: 20.75, 32.79) rather than by increases in spending per beneficiary, which were modest (average payment increase per beneficiary of $2.10; 95% CI: 0.22, 3.97). The charge-to-payment ratio decreased by 0.04 percentage points (95% CI: -0.08, -0.00) among MACRA participants, suggesting potential improvements in billing efficiency.

conclusionsMACRA participation is associated with increased billing and payment among Medicare Part B physicians, primarily driven by physicians treating a greater number of Medicare beneficiaries. However, modest changes in per-beneficiary spending suggest limited changes in care intensity. Further research is needed to explore factors influencing patient volumes and payer mix under MACRA.

Indexed as

Medicare Access and CHIP Reauthorization Act of 2015Medicare Part BPhysiciansPractice Patterns, Physicians'Centers for Medicare and Medicaid Services, U.S.Fee-for-Service PlansFemaleHumansMaleUnited StatesMACRA 2015Medicare part Bphysician billing behaviorphysician practicequality payment program

Identifiers

PMID40312801
PMCPMC12461111

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.