As part of the MACRA legislation that eliminated the problematic “Sustainable Growth Rate” (SCR) payment update mechanism, CMS combined three legacy incentive systems (meaningful use IT implementation, PQRS quality measure and the cost-based payment adjustment) into the QPP program for the large majority of clinicians (physicians, chiropractors, nurse specialists, physician assistants, clinical nurse midwives, podiatrists). Cynosure provided strategic development of the national support structure for QPP-SURS, is the lead liaison with the medical speciality societies and supports the monthly Learning and Action Network webinars as the facilitator.