LAUSR

On April 16, 2015, the Medicare Access & CHIP Reauthorization Act (MACRA) was signed into law. Motivated by a vision to move physician payment towards a more value-based system, this bipartisan legislation aims to establish the groundwork for advancing payment reform in traditional Medicare MACRA's initial achievement is the repeal of the sustainable growth rate formula. Yet its more enduring, substantive contribution to payment reform will likely be found in its creation of the Quality Payment Program. The Quality Payment Program diverges from traditional fee-for-service payment in 2 ways: by building incentives for value explicitly into the fee schedule, and by enhancing incentives for providers to enter payment models involving financial risk with both Medicare and other payers. The two strategies are embedded in distinct payment models. Providers are free to choose their path. In Spring of 2016, the Centers for Medicare and Medicaid Services published the proposed rule for the Quality Payment Program, containing specific details of policies for public comment. This article provides an overview of the Quality Payment Program and introduces the present theme issue of Healthcare: the Journal of Delivery Science and Innovation focused on applications of behavioral economics to physician incentives. Broadly, behavioral economics may impact provider behavior directly through the incentives within MACRA. It may also exert its impact through the design of internal incentives by physician organizations under population-based payment arrangements, which MACRA encourages. The articles in this issue explore these factors and others, with an emphasis on lessons from the implementation of incentives designed to encourage high-value care.