PracticeLink Magazine

Summer 2017

The career development quarterly for physicians of all specialties, PracticeLink Magazine provides readers with feature articles, compensation stats, helpful job search tips—as well as recruitment ads from organizations across the U.S.

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Page 35 of 87

36  S u MM e R 2017 department s Reform Recap Payments to Physicians and Hospitals Become Increasingly Quality-Based An increasingly important part of the payment system is the submission of data on quality measures, improvement activities and technology use. JEFF ATKINSON G o V e RNM e N t AND p RIVA te INS u R e RS AR e adopting payment plans based more on service quality and less on service quantity. At the end of 2016, the Centers for Medicare & Medicaid Services (CMS) issued regulations implementing the new Quality Payment Program, which will increase Medicare payments if quality goals are met and reduce them if goals are not met. ELIGIBILITY REQUIREMENTS The Quality Payment Program regulations apply to physicians who participate in the Medicare program, who bill Medicare for more than $30,000 per year and who provide care for more than 100 Medicare patients per year. Physicians who do not meet the eligibility requirements are not subject to the Quality Payment Program's benefits or penalties. The new regulations and the law that authorizes them add to the number of health care acronyms to keep track of. The law, which was passed by Congress in 2015, is the Medicare Access and CHI p Reauthorization Act (MACR A). The term "CHI p "— an acronym within an acronym — stands for the Children's Health Insurance Program. After passage of the law, CMS began drafting the rules to implement the law. CMS received more than 4,000 comments from people and organizations including physicians and professional associations. CMS then issued final rules that required more than 800 pages, including commentary on the rules. The goal of the program, according to the rule, is to support "transitioning from fee-for-service payments to payments for quality and value." The program replaces the prior systems — the Physician Quality Reporting System ( p QRS) and the Sustainable Growth Rate formula (S g R). The S g R formula was the statutory provision that Medicare payments to physicians would be sharply reduced each year unless Congress stepped in to stop the reduction —which Congress did, although sometimes after the rate cuts took effect for a few months.

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