In October 2016, the Centers for Medicare & Medicaid Services (CMS) announced its new Quality Payment Program (QPP) based on theMedicare Access and CHIP Reauthorization Act of 2015 (MACRA).
By instituting the QPP, CMS is furthering the movement to shift delivery and payment for
healthcare services from volume to value.Specifically, Medicare reimbursement will shift
from fee-for-service (FFS) to value-based payment programs. The QPP creates two new paths by which eligible clinicians will receive value-based Medicare reimbursement:
- The Merit-based Incentive Payment System (MIPS)
- Advanced Alternative Payment Models (APMs)
Now in its second year, the QPP emphasizes the CMS commitment to minimize the burden of participation and increase transparency.
The 2018 final rule attempts to:
- Support care improvement by focusing on better outcomes for patients and preserving the independent clinical practice
- Promote the adoption of APMs that align incentives for high-quality, low-cost care across healthcare stakeholders
- Advance existing delivery-system reform efforts, including ensuring a smooth transition to a healthcare system that promotes high-value, efficient care through unification of CMS legacy programs