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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
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.
- PolicyPromoting Transparency and Alignment in Medicare Advantage 10/2017
- PolicyReforming Medicare in the Age of Deficit Reduction 4/2012
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
Latest Advocacy Efforts
- LetterJoint Letter to CMS With Recommendations for Merit-Based Payment System (MIPS) Value Pathway Implementation 3/5/2021
- TestimonyACP Statement for the Record to the House Energy and Commerce Committee on Telehealth During COVID-19 2/2/2021
- LetterACP Comments on 2021 Final Physician Fee Schedule & Quality Payment Program Rule 2/1/2021
- LetterACP Comment Letter to CMS on Medicare Part B Most Favored Nation IFR 1/25/2021
- LetterACP Written Comments for CMS MVP Stakeholder Town Hall 1/14/2021
- SummaryACP Summary of 2021 Final Physician Fee Schedule & Quality Payment Program 12/23/2020
Search the ACP Policy Library
To access everything ACP has said related to Medicare reform issues search all policy statements, copies of testimony, and letters to government and non-government officials.
Medicare and the Quality Payment Program
Additional Advocacy Efforts
- ACP Says COVID-19 Relief Legislation Advances Essential Policies to Support Patients and Physicians 12/22/2020
- ACP Letter to President-Elect Biden Regarding Policy Recommendations for the New Administration 12/10/2020
- ACP Says 2021 Medicare Physician Fee Schedule and QPP Rule Makes Positive Steps, Improvements Still Needed 12/9/2020
- Joint Statement in Support of Increased Values for E/M Services in final 2021 Medicare Physician Fee Schedule 12/8/2020
- Letter to Secretary Azar in Opposition of the Proposed Rule "Securing Updated and Necessary Statutory Evaluations Timely" 12/4/2020
- Letter to Congress Urging Support to Improve Payment for Evaluation and Management Services in the 2021 Medicare Physician Fee Schedule 12/2/2020
- ACP Says Medicare’s Announced Payment Increases for Office Visits Are Essential to Patient Care 12/2/2020
- Joint Letter to Congressional Leadership in Support for Increased Investment in Primary Care 1/30/2020
- Quotes from Members of Congress Who Support Increased Payments for Evaluation and Management Services in Medicare 11/30/2020
- Joint Coalition Letter to Congress Urging Legislation to Hold Some Codes Harmless from Budget Neutrality For One Year and to Allow E/M increases, GPC1X to Move Forward 11/20/2020
- Coalition Letter on QP Threshold Increases 11/19/2020
- Joint Coalition Statement in Support of Medicare’s Plan to Pay More for Office Visits and Other Essential Services10/21/2020
- Joint Asks to Congress to Stabilize, Strengthen, and Sustain Primary Care During the COVID-19 Pandemic 10/7/2020
- ACP Comments on Proposed 2021 Medicare Physician Fee Schedule (PFS) Rule 10/2/2020
- Coalition Letter on ACO Changes in 2021 Proposed Physician Fee Schedule/Quality Payment Program Proposed Rule 9/23/2020
- ACP Comments to CMS/Acumen on MIPS Cost Measures Under Development 9/17/2020
- Internists Urge Congress to Support Planned Increases in Payments for E/M Services 9/11/2020
- ACP Cover Letter and Document to Members of Congress in Support of the 2021 Medicare Physician Fee Schedule Rule 9/11/2020
- ACP Summary of 2021 Proposed Physician Fee Schedule & Quality Payment Program 9/10/2020
- Internists Provide Recommendations to Improve PTAC Evaluation Process 8/14/2020
- ACP Comments to the PTAC in Response to Request for Public Input 8/13/2020
- Sign-On Letter to the PTAC in Response to Request for Public Input 8/13/2020
- Internists Say Quality Payment Program Needs to Better Accommodate Physicians Dealing with COVID-19 8/7/2020
- Internists Say Medicare’s Changes to Payments for Office Visits Will Help Physicians and Practices 7/24/2020
- Leading Health Groups Praise Introduction of Value in Health Care Act 7/24/2020
- ACP Comments on 2021 Inpatient Prospective Payment System Proposed Rule 7/9/2020
- Joint Letter to Congressional Leaders Supporting E/M Increases in 2021 Medicare Physician Fee Schedule Final Rule 7/6/2020
- Sign-On Letter to CMS Supporting CMS Finalized Documentation Guidelines for 2021 MPFS 6/30/2020
- ACP Urges CMS to Extend Flexibilities in the Quality Payment Program Due to the COVID-19 Crisis 6/12/2020
- ACP Letter to CMS with Recommendations for Long-term Recovery of Quality Payment Program from COVID-19 6/12/2020
- Response to CMS First Interim Final Rule on COVID-19 6/1/2020
- Coalition Letter on Supporting ACOs through COVID-19 Public Health Emergency 5/14/2020
- ACP Letter Requesting Additional Actions from CMS during COVID-19 Pandemic 5/7/2020
- Sign-On Letter in Support of CMS' MIPS Value Pathway to Reduce Burden and Focus Reporting on Patient Outcomes 4/10/2020
- ACP Recommendations to CMS regarding Coverage of and Payment for Telehealth During the 2019 Novel Coronavirus Disease (COVID-19) National Emergency 3/18/2020
- ACP Letter to Secretary Azar Regarding SARS-CoV-2 Virus and COVID-19 Virus 3/4/2020
- ACP's MIPS Value Pathway (MVP) Feedback and Proposal for 2021 Implementation 2/28/2020
- ACP Comments on 2020 Medicare Physician Fee Schedule (MPFS) Final 2/28/2020
- ACP Comment Letter to Representatives Regarding Strengthening Innovation in Medicare and Medicaid Act 2/18/2020
- ACP Subspecialty Sign-on Letter to CMS regarding E/M Codes 2/10/2020
- The "Medical Neighborhood" - Advanced Alternative Payment Model (AAPM) Proposal 1/28/2020
- ACP Letter to CMS Regarding Scope of Practice Requirements 1/17/2020
- ACP Comments on CMS’ Proposed Rule Updating Stark Law to Accommodate Value-Based Payments 12/31/2019
- ACP Comments on HHS OIG’s Proposed Rule Updating Anti-Kickback Statute to Accommodate Value-Based Payments 12/31/2019
- Internal Medicine Sign On Letter to Health Committees for E/M Fee Schedule Final Ruling 11/21/2019
- ACP Encouraged by Future Changes to MIPS, Urge Continued Focus on Burden Reduction in Final QPP Rule 11/7/2019
- Letter to Finance Committee Regarding E/M 2020 Fee Schedule Final Ruling 11/6/2019
- Letter to House Health Committees Regarding E/M 2020 Fee Schedule Final Ruling 11/6/2019
- Internists Applaud CMS for Raising Payments for Office Visits, Reducing Documentation in Final Payment Rule 11/4/2019
- Letter to HHS on Improving Medicare for Seniors 10/29/2019
- Rural ACO Improvement Act Sign-On Letter of Support 10/22/2019
- ACP One Pager Summarizing 2020 Physician Fee Schedule Recommendations 10/15/2019
- ACP One Pagers Summarizing 2020 Quality Payment Program Recommendations 10/15/2019
- Internists Commend CMS for Bolstering Primary Care and Supporting Patients in Proposed Physician Fee Schedule 9/27/2019
- ACP Comments on 2020 Medicare Physician Fee Schedule, Quality Payment Program, and other Medicare Part B Updates Proposed Rule 9/27/2019
- ACP Joins Eight Other Groups in Letter Urging CMS to Pay Out 2017 Advanced APM Bonuses 9/17/2019
- Summary of Physician Fee Schedule & Quality Payment Program Proposed Rule 2020 9/4/2019
- ACP Response to CMS Request for Information on Reducing Administrative Burden 8/12/2019
- Internists Applaud CMS for Putting Patients at the Center, Supporting Primary Care in Proposed Physician Fee Schedule 7/30/2019
- Letter to CMMI on Primary Care First Model 7/10/2019
- ACP Letter to Ways and Means Committee for June 26, 2019 Markup 6/25/2019
- ACP Response to the Ways and Means and Energy and Commerce Committees on Bipartisan Medicare Part D Drug Pricing Legislation 6/6/2019
- Joint Letter to Congress on MACRA Improvement Recommendations 6/3/2019
- ACP Response to CMMI RFI on Direct Contracting Model Geographic Option 5/30/2019
- ACP Letter to CMS on Development of a MIPS Outcome Measure for Hospital Admission Rates for Patients with Multiple Chronic Conditions 5/24/2019
- Statement for the Record: Senate Finance Committee Hearing on Medicare Physician Payment Reform After Two Years - Examining MACRA Implementation and the Road Ahead 5/8/2019
- Joint Letter to CMS on Medicare Appropriate Use Criteria (AUC) Program 4/29/2019
- Internists Encouraged By CMS Announcement of New Payment and Delivery Models to Support Primary Care 4/23/2019