Successfully transitioning to new payment systems and models

The Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) sunsets the Physician Quality Reporting System (PQRS), Value-Based Modifier (VM) and Medicare EHR Incentive programs. The new Quality Payment Program includes two paths: the Merit-based Incentive Payment System (MIPS) and Advanced Alternative Payment Models (APMs). Most Medicare clinicians will initially participate in the Quality Payment Program through MIPS. 

How We Can Help

Quality Insights Quality Innovation Network can assist clinicians in the transition from the existing Medicare reporting programs into the new Quality Payment Program. In 2017 and 2018, MIPS eligible clinicians (ECs) include physicians, nurse practitioners, physician assistants, clinical nurse specialists and certified registered nurse anesthetists. Additional provider types will be affected in future years. 

We can help clinicians better understand the four MIPS performance categories of quality, cost, advancing care information and clinical practice improvement activities and how the MIPS score will affect Medicare reimbursement. Our experts can provide information and education on Advanced Alternative Payment Models. Participants can earn free CME and CEU credits for completion of MIPS learning modules.

Additionally, participating clinicians will be alerted of Medicare regulatory changes as they occur and our team will assist with interpretation of quality and cost measure reports from CMS, previously known as Quality and Resource Use Reports (QRURs).  

What We Can Achieve Together

By maximizing Quality Insights’ offerings, healthcare providers across the network will:

  • Improve the quality of care delivered to patients
  • Increase the likelihood of receiving a positive Medicare payment adjustment instead of a negative or neutral payment adjustment
  • Increase participation in Alternative Payment Models

Join us on our journey to quality. By working together, we can transform the quality of healthcare for all.

Get Involved

Learn, report, improve and get paid. Quality Insights can help. Visit the Get Local section of this website to connect with your local project coordinator. 

Related Resources

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