Quality Initiatives

Quality initiatives and programs have become more prevalent in delivering healthcare and obtaining payment for services. Some programs offer bonuses or other incentives when quality measures are met, while others are more punitive in nature when measures are not met. Some quality programs are mandated by a plan or payor while others are more voluntary in nature. It is important to know how these programs function, their requirements for participation, and the opportunities they provide or disincentives they impose to evaluate if a program is a good fit for your practice and to ensure success.

Medicare Quality Payment Program

Provides a brief overview of the QPP and important dates.

Merit-based Incentive Payment System (MIPS) 

Summarizes MIPS participation requirements, reporting categories, data selection and submission, and performance reviews

MIPS Step-by-Step Guide

Guides are available for the 2022 and the 2023 performance years and provide a high-level overview and example of each performance category calculation, along with separate step-by-step guides with details on calculating, collecting, and reporting of each MIPS performance category and links to additional information.

Medicare Alternative Payment Models (APM)

Provides information on Medicare APMs and Advanced APMs, how to participate, and a list of Houston area APMs.

MIPS Value Pathways (MVPs)

Summarizes the QPP MVP track available in 2023.