Medicare Value-Based Programs

The national health care agenda is increasingly focused on improving the quality and safety of care provided to patients. As part of this shift, radiology practices must integrate value-driven infrastructure and quality-improvement programs by linking reimbursement to quality indicators.

Note: 2016 was the last program year for PQRS and Value Modifier programs. PQRS and VM transitioned to the Merit-based Incentive Payment System (MIPS) under the Quality Payment Program. The final data submission timeframe for reporting 2016 PQRS quality data to avoid the 2018 PQRS downward payment adjustment was January through March 2017. The first MIPS performance period is January through December 2017.

Quality Payment Program

MACRA legislation streamlines quality reporting into a single Quality Payment Program (QPP). QPP is a two-track system emphasizing value-based payment models (APMs and MIPS).
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Hospital Quality Programs

The Hospital Inpatient and Outpatient Quality Reporting Programs offer financial incentives to hospitals that provide higher levels of quality care.
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Physician Quality Reporting System

The PQRS program encourages eligible professionals to report quality measures intended to improve care and show opportunities for improvement. Participation is required to avoid payment reductions.
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Value-Based Payment Modifier

The Value-Based Payment Modifier program assesses both the quality and the cost of care under the Medicare Physician Fee Schedule.
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