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.
Note: You may sense that one of the stresses in each word is stronger than the other. You are right. When words are spoken in isolation, one syllable tends to get extra emphasis. The accent mark â indicates a weaker stress. sophistication. SophÃ¬sticÃ¡tion this difference is not important when analyzing metrical, rhythm so this article will mark only one level of. stress