Quality Payment Program

The number of quality and reimbursement programs continues to proliferate and so do the acronyms! Who has time to both practice medicine and keep up with regulations? Fortunately we can help with at least the regulatory part of the problem. Over the next 3 years healthcare providers will be hit a bewildering array of programs designed to change the way they practice medicine and certainly change the way they get paid! Below is a short description of the various regulations headed your way between now and 2019.

MACRA: QPP, MIPS and APMs

The Quality Payment Program (QPP) is the implementation of the Medicare Access and CHIP Reauthorization Act (MACRA) regulations of 2015. QPP will impact the reimbursements of virtually every practicing physician in the US. QPP has 2 components the Merit Based Incentive Payment System (MIPS) andAdvanced Alternative Payment Models (APMs). CMS estimates that 90% or providers will initially be covered under MIPS.

Starting in 2019 (and based on 2017 performance) MIPS will replace PQRS, VBM and Meaningful Use programs. MIPS is also a budget neutral program, like the VBM. Depending upon performance, under MIPS, Providers could be hit by a 4% penalty or incentive in 2019 BUT based on their 2017 performance. The penalties and incentives then increase to +/- 9% over the following 3 years.

We agree this is all very confusing and complicated! We would love to help you navigate this new world. Call us.