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Medicare's Value-Based Payment Program

The Value-Based Payment (VBP) program is intended to provide comparative performance information to physicians as part of Medicare’s efforts to improve the quality and efficiency of clinical care. This will be achieved by providing meaningful and actionable information to physicians so they can improve the care they furnish, and by moving toward physician reimbursement that rewards value rather than volume.

The program contains two primary components:

• Quality and Resource Use Reports (QRURs, also known as Physician Feedback Reports)
• Development and implementation of the value-based payment modifier (VBPM).

The ACA directs The Centers for Medicare & Medicaid Services (CMS) to provide information to physicians and medical practice groups about their resource use and quality of care provided to their Medicare patients, including quantification and comparisons of patterns of resource use/cost among physicians and medical practice groups.

The ACA mandates that CMS begin applying a value-based payment modifier under the physician fee schedule by 2015. In addition, this program must be implemented in a budget neutral manner.

More information on the Value-Based Payment Program:

• ACP Summary of the VBP program from the Medicare Physician Fee Schedule 2013 - Final Rule
• CMS on the Value-Based Purchasing Program finalized in the 2013 Physician Fee Schedule
• Linking Performance With Payment - Implementing the Physician Value-Based Payment Modifier. Article from the Journal of the American Medical Association
• ACP Internist Article Value-based payments a new source of reimbursement, penalties March 2013
• Medicare Learning Network - National Provider Calls
• Getting Started with PQRS Reporting: Implications for the Value-based Payment Modifier (6-5-13)
• CMS Plans for the Initial Implementation in 2015 of the Physician Value-Based Payment Modifier under the Medicare Physician Fee Schedule (11-28-12)

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