1 Repeals the flawed Medicare sustainable growth rate (SGR) formula that calculated payment cuts for physicians. 2  2016 through 2019: MACRA establishes a 0.5 percent physician fee schedule update each year.  January 2019: Based on qualification and eligibility, physicians may enter the APM track or the MIPS track.
In sociolinguistics, an accent is a manner of pronunciation peculiar to a particular individual, location, or nation. An accent may identify the locality in which its speakers reside, the socio-economic status of its speakers, their ethnicity, their caste or social class, their first language, and so on.
Regional accents are common in the U.S. She spoke with an American accent. The tourist had a foreign accent. He has a heavy southern accent. The word âbeforeâ has the accent on the last syllable. Put the accent on the first syllable of the word. The accents in the French word âÃ©migrÃ©â show how the letter âeâ should be pronounced.