Quality Payment Program

98% of Eligible Clinicians Avoided a MIPS Penalty in 2018

by Jacqueline LaPointe

About 98 percent of eligible clinicians avoided a penalty under the Merit-Based Incentive Payment System (MIPS) in 2018, and almost all of these clinicians earned a positive payment adjustment, CMS...

Clinicians to Earn MIPS Credit for Joining COVID-19 Clinical Trial

by Jacqueline LaPointe

Clinicians earning value-based reimbursement through the Merit-Based Incentive Payment System (MIPS) will be able to earn credit for participating in and reporting information on COVID-19 clinical...

CMS Relaxes Quality Reporting for Value-Based Purchasing Models

by Jacqueline LaPointe

Providers participating in some of Medicare’s largest value-based purchasing models will have some flexibility with quality reporting due to the ongoing COVID-19 pandemic, CMS announced last...

CMS Selects Participants for New Emergency Care Payment Model

by Samantha McGrail

CMS announced it selected 205 applications who will participate in the Emergency Triage, Treat, and Transport (ET3) Model, a payment model that ensures beneficiaries’ access to emergency...

Advanced Alternative Payment Model Participation Rose in 2018

by Jacqueline LaPointe

Over 84,200 more eligible clinicians sufficiently participated in one of the Quality Payment Program’s Advanced Alternative Payment Models (APMs) in 2018 compared to the previous year, according...

Prior Authorizations, Quality Payment Program Burden Practices

by Jacqueline LaPointe

A vast majority of medical group practices experienced growing regulatory burden in the last year, with prior authorizations and Medicare’s Quality Payment Program topping their list of the most...

CMS Says Clinicians to Receive Advanced APM Bonus Payments Soon

by Jacqueline LaPointe

In a fact sheet created on Sept. 27, CMS announced that Advanced Alternative Payment Model (APM) bonus payments for participation in an approved model in 2017 will be going out to qualifying clinicians...

Providers Ask CMS Where Their 2019 Advanced APM Bonus Is

by Jacqueline LaPointe

More than 90,000 clinicians are still waiting on the 2019 Advanced Alternative Payment Model (APM) bonus payment for their participation in 2017 and nine industry groups are demanding payment from...

Unpacking Proposed Merit-Based Incentive Payment System Changes

by Jacqueline LaPointe

CMS is planning to overhaul reporting for the Merit-Based Incentive Payment System (MIPS) in order to make the pay-for-performance program less burdensome and more meaningful to providers, according a...

Advanced APM Participation Almost Doubled from 2017 to 2018

by Jacqueline LaPointe

Advanced Alternative Payment Model (APM) participation in the Quality Payment Program (QPP) nearly doubled from 2017 to 2018, increasing from 99,076 to 183,306 clinicians, CMS recently reported in an...

As MACRA Implementation Turns 2, Industry Leaders Call for Change

by Jacqueline LaPointe

For the past two years, MACRA has been shifting providers away from fee-for-service to value. But industry leaders still have reservations about MACRA implementation and the law’s value-based...

MIPS Participation Reached 95% in 2017, Exceeding CMS Goals

by Jacqueline LaPointe

Ninety-five percent of eligible clinicians avoided a negative payment adjustment through Merit-Based Incentive Payment System (MIPS) participation in 2017, of which 93 percent earned a positive...

Rural, Small Practice MIPS Performance Lagged Behind Large Peers

by Jacqueline LaPointe

Rural and small practices fared worse than their large peers in MACRA’s Merit-Based Incentive Payment System (MIPS) in 2017, new research shows. Nearly one in five small practices received a...

Exploring Changes to the Quality Payment Program in 2019

by Jacqueline LaPointe

The final 2019 Medicare Physician Fee Schedule (PFS) rule contained a number of changes to evaluation and management (E/M) payment rates, site-neutral payments, and remote patient monitoring coverage....

Exploring Virtual Groups in the Quality Payment Program, MIPS

by Jacqueline LaPointe

Virtual groups enable independent physicians and clinicians in small practices to participate in Medicare’s historic push to transition to value-based reimbursement: the Quality Payment...

Quality Payment Program Top Regulatory Burden for Practices

by Jacqueline LaPointe

For the second year in a row, medical practice leaders said the Quality Payment Program was their top regulatory burden in 2018. Eighty-percent of the 426 group practice leaders recently surveyed by...

Do Proposed Quality Payment Program Changes Support Specialists?

by Jacqueline LaPointe

The American Society of Clinical Oncology (ASCO) recently expressed their concerns with proposed Quality Payment Program changes, arguing the potential implementation policies for the third year of the...

How Can CMS Improve MACRA’s Quality Payment Program, MIPS?

by Jacqueline LaPointe

While providers commend CMS for replacing the Sustainable Growth Rate with MACRA and its Quality Payment Program, many still have some reservations about the Medicare program. After completing the...

CMS Misses Chance to Move Physician Pay, QPP to Value, AMGA Says

by Jacqueline LaPointe

CMS recently proposed several changes to Medicare physician payments and MACRA’s Quality Payment Program to reduce medical billing and administrative burden. But initial reactions from medical...

CMS Proposes 2019 Physician Payment, Quality Payment Program Changes

by Jacqueline LaPointe

CMS recently proposed major changes to Medicare physician payments and the Quality Payment Program to reduce the administrative burden of medical billing. The potential changes in the Medicare...