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.
Thank you Daniel and Nida for your valuable replies...... Hi Raghavendra, for me, accent is the way how a language is spoken in a certain geographical area. For example, the English spoken in England sounds different from the one spoken in the USA. What about slang. I can say they are terms, vocabularies used by all social groups, which, in a way, expressing the way they see the world, society, historical events and so forth. Slangs are mutable along years, and vary too, regarding sex, age, walk of life, habits, culture, time ...