Medicare is shifting rapidly to value-based and integrated care. Notably, the Medicare Access & CHIP Reauthorization Act of 2015 (MACRA) initiated major changes in Medicare physician payment. In addition to ending the long reviled Sustainable Growth Rate (SGR) used to update Medicare professionals’ payments, MACRA creates two new value-based programs, which will rely on interoperable health IT (HIT). Payments will be affected by these models starting in 2019 (likely based on 2017 performance). The Centers for Medicare and Medicaid Services (CMS) has the lead, with the Office of the National Coordinator for Health Information Technology (ONC) focused on HIT aspects.