• Medicare Quality Payment Program (QPP)


    What is the Medicare Quality Payment Program (QPP)?

    The Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) developed the ground work a new program — the Quality Payment Program (QPP) — under which clinicians have the opportunity to earn bonuses, or face penalties, in the form of positive, neutral, or negative adjustments based on their performance in quality and cost measures. On November 4, 2016, CMS finalized its policy implementing the Medicare Quality Payment Program (QPP). The QPP shifts physician reimbursements from the traditional fee-for-service model to a value-based payment model. While this may seem like a new program, it is not unfamiliar from past CMS value-based programs such as PQRS, Meaningful Use, and the Value-Based Modifier program, that provided physicians with incentives and bonuses payments for reporting quality and cost data on their patients.


    The QPP offers two reimbursement/participation tracks for physicians under Medicare Part B:  


    Along with this finalized rule, CMS has launched their Quality Payment Program website which will explain the new program and help clinicians easily identify the measures most meaningful to their practice or specialty.  


    QPP Updates and Deadlines

    • Preview your 2018 MIPS Score - preliminary feedback on 2019 MIPS data submissions is now available via your QPP profile. 
    • 2019 MIPS Guides Now Available - Review our annual MIPS step-by-step guides to help you get started on your 2019 MIPS reporting. 
    • Check Your 2019 MIPS Eligibility - Check the QPP Participation Status Tool to view your eligibility status for the 2019 performance period under the MIPS. Enter your NPI to find out if you need to participate.
    • 2019 MIPS Measure Changes - Although you are now just beginning to report your 2018 MIPS data it is important to be aware of possible changes to your selected MIPS measures for the 2019 year. Reminder that the Quality category requires a full years worth of data in 2019 so it is important to begin collecting data now. Review our 2019 Measure Changes chart to identify if any of your current measures have been deleted or modified so you may make the appropriate changes in time. 
    • 2019 MIPS Changes - View our comparison chart to see what changes between 2018 and 2019 MIPS performance years have been made.