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 some contexts, the term stress or stress accent is used to mean specifically dynamic accent (or as an antonym to pitch accent in its various meanings). A prominent syllable or word is said to be accented or tonic; the latter term does not imply that it carries phonemic tone. Other syllables or words are said to be unaccented or atonic.