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.
In music, an accent is an emphasis placed on a particular note, either as a result of its context or specifically indicated by an accent mark.Accents contribute to the articulation and prosody of a performance of a musical phrase. Compared to surrounding notes:1  A dynamic accent or stress accent is an emphasis using louder sound, typically most pronounced on the attack of the sound. 2  A tonic accent is an emphasis on notes by virtue of being higher in pitch as opposed to higher in volume.ompared to surrounding notes: 1  A dynamic accent or stress accent is an emphasis using louder sound, typically most pronounced on the attack of the sound. 2  A tonic accent is an emphasis on notes by virtue of being higher in pitch as opposed to higher in volume.