Medicare’s Quality Payment Program (QPP)
What's New
In response to the COVID-19 pandemic and the ACP’s advocacy, CMS extended the MIPS extreme and uncontrollable circumstances exception. Applications for the 2022 performance year are due March 3, 2023. Find more information here. Read more about the QPP COVID-19 response here.
In an updated white paper released in November 2022, the CMS Innovation Center (CMMI) detailed its new strategic vision of transformation of the US health care system by establishing equitable outcomes through high quality, affordable, person-centered care, which closely aligns with the policies of ACP. ACP expressed support for CMMI’s goals in a statement on the white paper. Learn more here.
CMS published the 2023 Medicare Physician Fee Schedule/QPP Final Rule on November 18, 2022. Read ACP's detailed summary (ACP Member login required) and comments of the final rule.
MIPS
Merit-Based Incentive Payment System
The Merit-Based Incentive Payment System (MIPS) adjusts payments based on a clinician's performance across 4 categories: Quality (30%), Promoting Interoperability (25%), Improvement Activities (15%), and Cost (30%). Learn more
APMs
Alternative Payment Models
APMs structure payment to incentivize quality and value. Clinicians who participate in certain “Advanced APMs” that satisfy advanced risk, quality, and technology requirements may be excluded from MIPS and eligible for a 5% Medicare bonus. Learn more
Other Value-Based Payment Reform Efforts
Medicaid, Medicare Advantage, and private payers have increasingly been developing their own quality performance programs and APMs. To the right is the breakdown of value-based payments for commercial, Medicaid Advantage, and Medicaid payers, based on 2022 data.
Source: Health Care Payment Learning & Action Network
ACP Advocacy
Read how ACP advocated on behalf of clinicians and influenced the MACRA Rules:
- ACP Summary of 2023 Medicare Physician Fee Schedule (MPFS) & Quality Payment Program (QPP) Final Rule ACP Member Exclusive
- ACP Comments to CMS on 2023 MPQS & QPP Final Rule
Learn about ACP’s latest advocacy efforts to reform and improve the Quality Payment Program. Learn more
For more information or questions or concerns regarding specific QPP/MACRA-related issues, email policy-regs@acponline.org.