The Medicare Access and CHIP Reauthorization Act of 2015, or MACRA, shifts the Medicare payment base from volume to value. This landmark legislation aims to move Medicare from fee-for-service to a system that rewards quality and low cost. As recently as the summer of 2016, 50% of physicians had not heard of MACRA. In what can only be viewed as an accelerated timetable, even by government standards, the law passed in 2015 was followed by a final rule in 2016 and then