Quality Payment Program (QPP) - MIPS and Advanced APMS

The Centers for Medicare and Medicaid Services (CMS) has developed the Quality Payment Program (QPP) for clinicians who bill Medicare Part B. QPP has two tracks:

  • The Merit-based Incentive Payment System (MIPS)
  • Advanced Alternative Payment Models (APMs)

Read our MIPS 2017 Policy Update to understand changes to Advancing Care Information exclusions and attestation

Eligible clinicians who participate in MIPS 2017 Transition Year will be eligible for a payment adjustment up to +4% in 2019. Eligible clinicians who do not participate will receive a -4% payment adjustment in 2019. Eligible clinicians’ MIPS 2017 performance will be publicly available on Physician Compare.

An APM is a payment approach that trends away from the fee-for-service model and toward value-based-care. An Advanced APM takes this model one step further and requires practices to take on financial risk related to their patient’s outcomes.

CMS released the proposed rule for QPP Year 2 (2018) on June 20, 2017. Review the Proposed Rule Fact Sheet for more information.  The final ruling is expected to be released in the fall of 2017.

Overview of Transition Year 2018 MIPS program and eligibility requirements.

Overview of Transition Year 2017 MIPS program and eligibility requirements

Details about Transition Year 2017 MIPS data submission methods.

Guidance on how your Transition Year 2017 MIPS data will be scored.

Assistance on selecting Transition Year 2017 MIPS Quality measures. The Quality performance category was formally known as the Physician Quality Reporting System or PQRS.

Information about the Advancing Care Information (ACI) performance category for MIPS Transition Year 2017.

Facts about the Improvement Activities performance category for the MIPS 2017 Transition Year.  This is a new performance category in 2017.