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Quizzes > Quizzes for Business > Healthcare

Test Your MACRA Basics Quiz Knowledge

Assess Value-Based Care Fundamentals With Confidence

Difficulty: Moderate
Questions: 20
Learning OutcomesStudy Material
Colorful paper art illustrating a trivia quiz on MACRA basics.

Ready to master the essentials of MACRA? This MACRA Basics Quiz lets healthcare professionals test their grasp of MIPS, APMs, and reporting standards through 15 engaging questions. Participants can refine their knowledge, improve compliance strategies, and explore value-based care concepts. Questions are fully editable in our quizzes editor, so instructors can tailor them to any curriculum. For more practice, try the E/M Coding Basics Quiz or the Financial Management Basics Quiz.

What does MACRA stand for?
Medical Access and Care Reform Act
Medicare Access and CHIP Reauthorization Act
Medicare Administration and Cost Reduction Act
Medicaid Accountability and Clinical Reform Act
MACRA is the acronym for the Medicare Access and CHIP Reauthorization Act of 2015. It reformed how Medicare reimburses clinicians by introducing MIPS and APMs.
Which two payment pathways did MACRA establish?
Fee-for-Service and Bundled Payments
Merit-based Incentive Payment System and Alternative Payment Models
Accountable Care Organizations and Shared Savings Only
Capitation and Value-Based Purchasing
MACRA created the Merit-based Incentive Payment System (MIPS) and the Alternative Payment Models (APMs) as the two main pathways. These replaced previous incentive programs.
Which federal agency administers MACRA?
Food and Drug Administration
National Institutes of Health
Centers for Medicare & Medicaid Services
Office of the Inspector General
The Centers for Medicare & Medicaid Services (CMS) is responsible for implementing and administering MACRA. CMS sets policies and oversees reporting and payment adjustments.
How long is the typical performance period for MIPS?
Six months
One year
Two years
Three months
MIPS performance is evaluated over a one-year period. Clinicians collect and report data throughout that full year for each performance category.
Which of the following is NOT a MIPS performance category?
Cost
Promoting Interoperability
Technology
Quality
The four official MIPS categories are Quality, Cost, Improvement Activities, and Promoting Interoperability. Technology is not one of these categories.
How many performance categories are included in the MIPS scoring system?
5
3
4
6
MIPS scoring is based on four performance categories: Quality, Cost, Improvement Activities, and Promoting Interoperability.
Which MIPS performance category evaluates the resources used for patient care?
Cost
Promoting Interoperability
Improvement Activities
Quality
The Cost category measures resource use and spending associated with the care provided. It evaluates the efficiency of clinical services.
Which of these is a requirement for a payment model to qualify as an Advanced APM?
It must have no performance-based financial risk
It must require use of certified electronic health record technology
It must be based solely on fee-for-service
It must only include hospital outpatient services
Advanced APMs must require participants to use certified EHR technology. They also typically include downside financial risk or use quality measures.
Which mechanism can clinicians use to report Quality measures under MIPS?
Health Information Exchange
Medical Licensing Board
Peer Review Organization
Qualified Registry
Clinicians can report Quality measures through a CMS-qualified registry known as a Qualified Registry. This is one of several approved submission mechanisms.
Under the MIPS low-volume threshold, clinicians with Medicare Part B allowed charges below what amount are excluded?
$50,000
$200,000
$90,000
$150,000
Clinicians with Medicare Part B charges under $90,000 in the performance year are excluded from MIPS. This is known as the low-volume threshold.
To achieve "Qualified Participant" status in an Advanced APM, clinicians must receive at least what percentage of their Medicare payments through the Advanced APM?
50%
90%
25%
75%
Clinicians must have at least 50% of their Medicare Part B payments through an Advanced APM to be considered a Qualified Participant (QP).
Which MIPS performance category focuses specifically on the use of certified electronic health record technology?
Promoting Interoperability
Cost
Improvement Activities
Quality
The Promoting Interoperability category measures how well clinicians use certified EHR technology to improve care, formerly known as the EHR Meaningful Use program.
Which of the following best describes Improvement Activities in MIPS?
Metrics for electronic prescribing
Measures of resource use and spending
Clinical practice enhancements that improve patient care processes
Benchmarks for sustainable growth rate
Improvement Activities reward clinicians for engaging in activities that proactively improve clinical practice and patient outcomes, such as care coordination and patient engagement.
Which of the following payment models is considered an Advanced APM?
Bundled Payments for Care Improvement Initiative
Medicare Shared Savings Program Track 1
Hospital Outpatient Quality Reporting
Medicare Shared Savings Program Track 2
MSSP Track 2 requires participants to share in both savings and losses, meeting the downside risk and quality criteria that qualify it as an Advanced APM.
Dr. Smith sees 150 Medicare patients and has $80,000 in Part B allowed charges. Under the low-volume threshold, is he required to report MIPS?
No, because his allowed charges are below the $90,000 threshold
Yes, because any number of patients triggers reporting
No, because he sees fewer than 200 patients regardless of charges
Yes, because he sees more than 100 patients
Dr. Smith's Medicare Part B charges are below the $90,000 low-volume threshold, which excludes him from MIPS reporting requirements for that performance year.
A MIPS clinician receives these category scores: Quality 60, Promoting Interoperability 80, Improvement Activities 50, Cost 40. If weights are Quality 30%, PI 25%, IA 15%, Cost 30%, what is the composite performance score?
62.5
58.5
53.5
57.5
The weighted score is calculated as 0.30Ã - 60 + 0.25Ã - 80 + 0.15Ã - 50 + 0.30Ã - 40 = 18 + 20 + 7.5 + 12 = 57.5. This yields a composite score of 57.5.
Under MIPS Improvement Activities, how many medium-weight activities must be performed to earn full credit for that category?
4
3
1
2
Clinicians must complete two medium-weight activities (or one high-weight activity) to earn the full Improvement Activities category score.
To achieve full credit for a MIPS Quality measure, what is the minimum data completeness threshold clinicians must meet?
70%
60%
80%
50%
Quality measures require at least 70% data completeness of all eligible cases to earn full points. This ensures sufficient reporting for valid performance assessment.
Dr. Jones participates in MSSP Track 2 Advanced APM and receives 40% of her Medicare payments through the APM. What is her QP status?
Not Participating
Partial Qualified Participant
Qualified Participant
Advanced APM Exempt
With 40% of payments through the Advanced APM, Dr. Jones falls between the partial QP threshold (25%) and full QP threshold (50%), making her a Partial Qualified Participant.
What is the percentage bonus Medicare provides to clinicians who are Qualifying Participants in an Advanced APM?
10%
5%
3%
7%
Advanced APM participants who achieve Qualified Participant status receive a 5% Medicare bonus on their payments. This incentivizes participation in risk-bearing models.
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Learning Outcomes

  1. Identify key components of MACRA structure and goals.
  2. Explain MIPS performance categories and scoring.
  3. Evaluate eligibility criteria for APM participation.
  4. Demonstrate understanding of QPP reporting requirements.
  5. Apply knowledge to real-world clinician scenarios.

Cheat Sheet

  1. Understand MACRA's Purpose - MACRA, enacted in 2015, overhauled Medicare reimbursement by swapping out the Sustainable Growth Rate formula. This shift moved payments from a volume-based to a value-based model, rewarding care quality over quantity. It laid the groundwork for ongoing performance-driven incentives. CMS Quality Payment Program
    2. Learn more
  2. Explore the Quality Payment Program (QPP) - Dive into the QPP to discover two unique participation tracks: MIPS and Advanced APMs. Each path comes with its own set of requirements, scoring methods, and financial rewards. Choosing the right track can align your practice with performance goals and patient outcomes. QPP Details
    3. Learn more
  3. Delve into MIPS Performance Categories - MIPS scores clinicians across four areas: Quality, Promoting Interoperability, Improvement Activities, and Cost. Each category contributes a specific percentage toward the final performance score. Understanding these pillars helps you target improvements and boost your reimbursement potential. ACP MIPS Overview
    4. Learn more
  4. Grasp MIPS Scoring and Weighting - Each MIPS category carries a designated weight toward your overall score - Quality might be 30%, while Cost could be 20%. These weights directly influence whether you receive a bonus, penalty, or neutral payment adjustment. Smartly allocating effort across categories maximizes your financial return. ACP MIPS Scoring
    5. Learn more
  5. Recognize MIPS Eligibility Criteria - Clinicians billing over $90,000 in Medicare charges and treating more than 200 Medicare patients per year must participate in MIPS. Falling below these thresholds exempts you from reporting, so it's key to track your volume. Meeting or exceeding them unlocks both opportunities and responsibilities. ACP MIPS Eligibility
    6. Learn more
  6. Understand Advanced APMs - Advanced Alternative Payment Models require certified EHR technology, quality-based payment structures, and carrying more than nominal financial risk. Participants engage in bundled payments, shared savings, or capitation arrangements. These models can drive innovation and align incentives for patient outcomes. CMS APM Fact Sheet
    7. Learn more
  7. Learn APM Participation Benefits - Clinicians in qualifying Advanced APMs can earn a 5% incentive payment on Medicare reimbursements. Plus, they're exempt from MIPS reporting requirements, simplifying compliance. This dual advantage rewards quality-driven care with both bonuses and less administrative burden. ACC APM Brief
    8. Learn more
  8. Identify APM Eligibility Requirements - To qualify for Advanced APM incentives, clinicians must meet set thresholds for payments or patient counts under the model. Tracking your participation rate ensures you hit the minimum targets. Meeting these benchmarks is critical to secure incentive payments and MIPS exemption. CMS APM Eligibility
    9. Learn more
  9. Comprehend QPP Reporting Requirements - Accurate and timely reporting in MIPS or Advanced APMs is essential for avoiding penalties and unlocking incentive payments. Data must be clean, complete, and submitted through the proper CMS portal. Mastering this process turns paperwork into a strategic tool instead of a hurdle. AMA QPP FAQs
    10. Learn more
  10. Apply Knowledge to Clinical Scenarios - Leveraging MACRA's components empowers clinicians to optimize both patient care and financial performance. Familiarity with MIPS and APMs guides decision-making around workflows, documentation, and technology use. Real-world scenarios help translate theory into everyday practice improvements. AMA QPP Application
    11. Learn more
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