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What are QPP?

What are QPP?

The Quality Payment Program (QPP) was created by the Medicare Access and CHIP Reauthorization Act (MACRA) of 2015. The QPP transforms the Medicare physician payment system from one focused on volume to one focused on value. Start now to get ready—2017 reporting will affect 2019 payments!

What is the purpose of the Physician Compare tool that is a part of the CMS website?

Developed as part of the Patient Protection and Affordable Care Act (ACA) of 2010 to increase transparency by publicly reporting data on providers, the Centers for Medicare and Medicaid Services (CMS) designed the Physician Compare website to help patients obtain data about Medicare-participating physicians.

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What two programs did CMS implement as quality payment incentives which rewards value and outcomes?

Beginning in 2019, health care providers will be paid through one of two pathways that will link payments to the quality of care provided: the Merit-Based Incentive Payment System (MIPS) or Alternative Payment Models (APMs). Together, the MIPS and APM tracks make up the QPP.

What is a Qpp exception?

The Extreme and Uncontrollable Circumstances Exception application allows you to request reweighting for any or all performance categories if you encounter an extreme and uncontrollable circumstance or public health emergency, such as COVID-19, that is outside of your control.

How did Qpp come about?

The QPP was created by the Medicare Access and CHIP Reauthorization Act (MACRA) and creates two payment pathways for physicians—alternative payment models (APMs) and the Merit-based Incentive Payment System (MIPS).

Why was Qpp created?

The new Quality Payment Program (QPP) is designed to reward physicians for demonstrating a high level of quality of care or participating in new models of care that reward quality and efficiency.

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What is the purpose of websites such as physician compare?

Currently, Physician Compare is a website that allows consumers to search for, and obtain information about, physicians and other healthcare professionals who provide Medicare services.

How does CMS reimbursement work?

The Centers for Medicare and Medicaid (CMS) sets reimbursement rates for all medical services and equipment covered under Medicare. When a provider accepts assignment, they agree to accept Medicare-established fees. Providers cannot bill you for the difference between their normal rate and Medicare set fees.

How does Medicare influence quality reporting systems?

For more information about PQRS payment adjustments visit the Payment Adjustment Information webpage. EPs who report PQRS quality measures data can request to receive National Provider Identifier (NPI)- level Physician Quality Reporting Feedback Reports.

What is the promoting interoperability program?

In 2011, CMS established the Medicare and Medicaid EHR Incentive Programs (now known as the Promoting Interoperability Programs) to encourage EPs, eligible hospitals, and CAHs to adopt, implement, upgrade, and demonstrate meaningful use of certified electronic health record technology (CEHRT).

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What are MIPS in healthcare?

The Merit-Based Incentive Payment System (MIPS) is the program that will determine Medicare payment adjustments. Using a composite performance score, eligible clinicians (ECs) may receive a payment bonus, a payment penalty or no payment adjustment.