Quality Payment Program

What’s the Quality Payment Program?

The Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) ended the Sustainable Growth Rate (PDF) (SGR) formula, which would have significantly cut payment rates for participating Medicare clinicians. MACRA requires us to implement an incentive program, the Quality Payment Program. There are 2 ways clinicians can choose to participate in the Quality Payment Program:

1. The Merit-based Incentive Payment System (MIPS): If you’re a MIPS eligible clinician, you’ll be subject to a performance-based payment adjustment through MIPS.
2. Advanced Alternative Payment Models (APMs): If you decide to take part in an Advanced APM, you may earn a Medicare incentive payment for sufficiently participating in an innovative payment model.

For your reference

• Get fact sheets from the QPP resource library.
• Attend or replay webinars.
• Learn more about the Physician Focused Payment Models (PFPMs) Technical Committee.
• Read and comment on the patient relationship categories and codes.
• Find the Episode Groups summary and make comments on the Supplemental Episode Groups (PDF), Episode Workbooks (ZIP), and Design Report (PDF).
• Request a CMS speaker to give your group more details about the Quality Payment Program.