Medicare Quality Payment Program

Introduction

Program under Medicare Access & Chip Reauthorization Act (MACRA).

Program affects clinicians who

• who bill Medicare > $30,000 a year
• provide care for > 100 Medicare patients annually

Affected clinicians include:

• physicians
• physician assistants
• nurse practitioners
• clinical nurse specialists
• certified registered nurse anesthetists

Clinicians allowed to choose:

• Merit-based Incentive Payment System (MIPS)
  • payment adjustment based on evidence-based & practice- specific quality data
• Advanced Alternative Payment Models (APMs).
  • earning for taking on some risk related to their patient outcomes (5% incentive payment)

Additional terms

• Medicare Access & CHIP Reauthorization Act (MACRA)