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MACRA and the Quality Payment Program

 

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 through 2022. Applications for the 2022 performance year are due December 31, 2022. Find more information here. Read more about the QPP COVID-19 response here.

In a white paper released in October 2021, 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.

2022 Medicare Physician Fee Schedule/QPP Final Rule CMS finalized the rule on November 2, 2021. Read ACP’s detailed summary and analysis 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 2021 data.

Source: Health Care Payment Learning & Action Network

 


ACP Advocacy

Read how ACP advocated on behalf of clinicians and influenced the MACRA Rules:

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. We also encourage you to discuss QPP/MACRA with your colleagues in the Member Forum on MACRA.

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