Quality Payment Program

Overview

The Quality Payment Program (QPP), established under MACRA, is the new Medicare value-based reimbursement system. The QPP rewards physicians and clinicians for giving better care, not just more care. In short, Medicare payments are aligned with quantifiable performance and quality metrics. To ensure there are relevant quality measures from which eligible anesthesia clinicians can select, AQI is working with physician anesthesiologists and CMS to develop and obtain approval for measures.

The QPP has two reimbursement tracks:

The Merit-based Incentive Payment System (MIPS)

Physicians participating in MIPS can potentially earn a performance-based upward payment adjustment to their Medicare Part B payments based upon their performance in four categories.

Advanced Alternative Payment Models (APMs)

Those eligible clinicians and practices participating in the APM model are rewarded for taking on some risk related to their patients’ outcomes. Advanced APMs seek to incentivize providers to lower costs, while improving care.