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Medicare and the Quality Payment Program

    Background

    Value-based payment reform efforts can vary in structure and design. Pay-for-reporting and pay-for-performance programs offer financial incentives, and in some cases financially penalize clinicians, based on their performance on quality, cost, and other performance metrics. Alternative Payment Models (APMs) vary in design but all aim to restructure payments in a way that financially incentivize low-cost, high-value care.

    ADVOCACY WIN

    Joint Congressional Briefing About the Need to Stabilize, Strengthen and Sustain Primary Care During the COVID-19 Pandemic

    ACP joined with the American Academy of Family Physicians and the American Academy of Pediatrics to hold a virtual briefing to tell congressional staffers what Congress should do to help primary care physicians deal with the impact of the COVID-19 pandemic.

    Where We Stand

    ACP supports the goal of aligning physician payments with the efficient delivery of high quality care to patients. ACP also supports leveraging value-based payment to do away with unnecessary administrative burdens that divert physicians away from patient care. For the transition to work, performance measures used for payment or public accountability must be evidence-based, clinically relevant, and appropriate; and internists must be given ample opportunity to participate in a range of diverse alternative payment models that can accommodate a wide range of specialties, practice sizes, and unique patient populations. ACP has called on CMS to improve the current Quality Payment Program by improving the accuracy of performance metrics, streamlining MIPS subcategories and scoring, doing more to correct the performance gap for small and rural practices, and create more Advanced APMs. In the 2020 final Physician Fee Schedule, CMS announced plans to replace the existing MIPS Program with the new “MIPS Value Pathway,” which will begin to be phased in starting in 2021. ACP is actively working with CMS and other stakeholders to design this new program to make it work for internists and their patients. ACP has also pressed for multi-payer alignment of performance metrics and value-based payment initiatives to minimize burden on physicians.

    Video: Joint Congressional Briefing

    Joint Congressional Briefing About the Need to Stabilize, Strengthen and Sustain Primary Care During the COVID-19 Pandemic (10/7/2020)

    ACP joined with the American Academy of Family Physicians and the American Academy of Pediatrics to hold a virtual briefing to tell congressional staffers what Congress should do to help primary care physicians deal with the impact of the COVID-19 pandemic. Watch Video

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    Medicare and the Quality Payment Program

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