When the Centers for Medicare and Medicaid Services (CMS) released the Final Rule on the Medicare Access and CHIP Reauthorization Act (MACRA) on October 14th, healthcare employees around the nation could finally stop holding their breath. The exhale wasn’t exactly one of gratification, but more one of relief to finally know what will be impacting their future payments. Providers have been on edge since 2015 when MACRA first passed, their objections known loud and clear from the start. While the final rule did lessen the blow of many of the parameters, the changes are coming down the pipeline quickly and will have to be adopted very soon. MACRA will begin to take effect in 2017 with performance beginning to impact their payments in 2019.