Presence Health

Our Health Care Payment Landscape

Attention Physicians: Our website has been updated with accurate 2018 Performance Year reporting information.

The Medicare Access and CHIP Reauthorization Act (MACRA) was passed in 2015 to establish a new health care payment program, known as the Quality Payment Program (QPP) that offers eligible health care professionals multiple ways of paying for care. Developed by the Centers for Medicare & Medicaid Services (CMS), the QPP makes Medicare better by helping you focus on care quality and the one thing that matters most – making patients healthier. The Quality Payment Program ends the Sustainable Growth Rate formula and gives you new tools, models, and resources to help you give your patients the best possible care. It accommodates the following programs within CMS: Physician Quality Reporting System, the Value Modifier, and the Medicare Electronic Health Record.

The Quality Payment Program has two reimbursement tracks: Advanced Alternative Payment Models (APMs) or the Merit-based Incentive Payment System (MIPS). Your track depends on your practice size, specialty, location, and patient population.

Providers participating in the Merit-based Incentive Payment Systems (MIPS) receive adjustments to the base rate of their Medicare Part B Payment, beginning in 2019, that will increase over the years until 2022.

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Assessing the value of care to ensure patients get the right care at the right time

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Helps create efficiencies in Medicare spending and rewards for high quality and low cost care

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Supports care coordination, patient engagement, patient safety, population management, and health equity


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Promoting Interoperability (also known as ACI).