The Quality Payment Program/ MACRA
The Quality Payment Program as part of The Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) is a bipartisan federal legislation. MACRA repeals the Sustainable Growth Rate (SGR) Formula that has determined Medicare Part B reimbursement rates for physicians and replaces it with new ways of paying for care.
Under the Quality Payment Program, participating providers will be paid based on the quality and effectiveness of the care they provide. A large percentage of the physician payment will be based on value and outcomes of their care (not on volume). High value care commonly referred to as value-based care will be defined by measures of quality and efficiency and providers will be incentivized or decremented based on their performance against those measures.
CMS believes that the Quality Payment Program improves Medicare by helping you focus on care quality and the one thing that matters most — making patients healthier.
The Quality Payment Program has two tracks you can choose from:
2020: TWO PATHWAYS FOR PAYMENTS
MERIT-BASED INCENTIVE PAYMENT SYSTEM
ALTERNATIVE PAYMENT MODELS
For 2020 reporting period, a MIPS eligible provider or practice has billed for more than $90,000 and has provided care for more than 200 patients.
Quality Payment Program Participants
You are eligible to participate in the MIPS track of the Quality Payment Program if you bill more than $90,000 to Medicare, and provide care to more than 200 Medicare patients per year, and you are one of the following:
If 2018 is your first year participating in Medicare, then you are not required to participate in the Quality Payment Program in 2018.
Contact Us Today to Learn How We Can Successfully Assist You in Participating in the Quality Payment Program (QPP)