Medicare Value-Based Payment and Quality Reporting for Physician Services: Navigating Recent Changes

Description

In response to rising health care costs and the concern that fee-for-service reimbursement rewards quantity instead of quality, Congress established several programs to reward value and care coordination among providers, including the Physician Quality Reporting System (PQRS), the Value-Based Payment Modifier (VBPM) and the EHR Incentive Program.

It is critical for physicians and other Eligible Professionals to understand the changing reporting requirements for these programs for 2015 to earn incentive payments and avoid Medicare reimbursement penalties.

Congress and the Centers for Medicare & Medicaid Services (CMS) initially made quality reporting voluntary and rewarded Eligible Professionals with incentive dollars for participating in quality reporting programs. This year, however, Eligible Professionals will begin to see reductions to their Medicare reimbursement if they have not elected to participate. These reimbursement penalties will rise to up to 9% of the amount otherwise paid under the Medicare Physician Fee Schedule in 2017 for Eligible Professionals who do not report quality measures and participate in the Medicare EHR Incentive Program this year.

Listen as our authoritative panel of healthcare attorneys examines the 2015 changes to PQRS and VBPM adopted by CMS in the 2015 Medicare Physician Fee Schedule regulations, as well as the 2015 clinical quality measure reporting requirements of the Medicare EHR Incentive Program. The panel will discuss what these changes mean, offer best practices for meeting Medicare’s quality reporting requirements, and provide an outlook on the future of quality data reporting and pay for performance under the traditional Medicare fee-for-service program.