What should you know about Medicare's new quality payment program?

Tags: Quality improvement program, medicare, TMF, APMs, MIPS, QRUR, CMS, PQRS

By Suzie Buhr, BSN, RN, CPHQ
Quality Improvement Consultant for TMF Health Quality Institute


Just when your physician practice successfully participated in the Physician Quality Reporting System or achieved Meaningful Use with your electronic health record, along comes a new payment program from the Centers for Medicare and Medicare Services. Beginning next year, your practice will be evaluated for the data you report in 2017, which will affect payments in 2019. The good news is by participating in PQRS and meaningful use now, you are moving in the right direction. The work you are doing for those programs will help you transition to participating in either the Merit-based Incentive Payment System or the Alternative Payment Model program. What do you need to know now to prepare for the transition?

Lucky for you, CMS has published several documents and resources to help you become familiar with components of the new Quality Payment Program, including the Medicare Access and CHIP Reauthorization Act of 2015, MIPS and APMs. Follow the links below to learn more.

To stay up do date on the latest quality reporting and incentive program updates, visit the Value-Based Improvement and Outcomes Learning and Action Network hosted by the TMF Quality Innovation Network. Network membership is free.

Upcoming Events

The TMF Quality Innovation Network is hosting the following upcoming events for the benefit of physicians and hospital health care professionals. Mark your calendars and plan to attend. You can learn more by visiting www.TMFQIN.org and clicking on the “Events” tab.

Tuesday, July 26, 12:30-1:30 CT
Secrets Revealed: Improving your Quality Resource Use Reports using CMS Benchmarks
Adrian Nedelcut, quality improvement manager at the University of Texas Health Science Center at Tyler, will provide information about achieving Value Modifier financial incentives by drilling down into the components of the health system’s Quality Resource Use Reports, identifying quality and cost improvement areas and using benchmarks from CMS. Physicians and quality improvement staff from physician practices and hospitals are encouraged to attend this presentation.

Tuesday, Aug. 16, 2016, 12:30 – 1:30 p.m. CT
The Quality Payment Program: What do MIPS and APMs mean for your organization?
At this presentation, a representative from CMS will discuss the Quality Payment Program, the Merit-based Incentive Payment System and incentives for participation in Advanced Alternative Payment Models. Physicians and quality improvement staff from physician practices and hospitals are encouraged to attend this presentation.

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