How To Meet the Needs of CMS’ New Quality Payment Program

February 2, 2017

If your clinic participates in Medicare Part B, you are part of the dedicated team of clinicians who serve more than 55 million of the country’s most vulnerable Americans.

The new Quality Payment Program (QPP) from Centers for Medicare and Medicaid (first announced as “MACRA” in January 2015) provides new tools and resources to help you give your patients the best possible care. The Quality Payment Program achieves the following:

  • Repeals the Sustainable Growth (SGR) Formula
  • Streamlines multiple quality reporting programs into the new Merit-based Incentive Payment System (MIPS)
  • Provides incentive payments for participation in Advanced Alternative Payment Models (APMs)

What does this mean for your practice? It means adopting new policies and practices to help you monitor and care for patients at a group level. Like any change, QPP requires both business and clinical leadership to state the goals and achieve them.

Don’t let this new program sneak up and surprise you. In these first weeks of 2017, HealthCo team members have been speaking with our partners in clinics that are now starting to see their first penalties associated with abstaining from Meaningful Use programs, and some are shocked at the adjustments. Thankfully, the HealthCo team is ready to answer your questions and help you adjust workflows, as needed. There are also great resources to help you navigate QPP, including this New White Paper from GE Healthcare.


In lieu of a future deep dive into the topic, we have a few quick tips to get you started:

  • Determine which providers are eligible: Research the rules to make certain you understand which of your providers meet the criteria to participate in QPP.
  • Assess how quickly you want to move: CMS has given you several options for participation from submitting nothing to submitting partial or full-year data.
  • Assess group or individual participation: When reporting as a group there are additional methods for reporting on Quality and Advancing Care measures, so make sure you are clear on your clinic’s reporting status.

Wading through white papers on legislative changes can be time-consuming and dense reading. Remember, we are just a phone call away. Our team of rock star trainers can walk you through the all the various QPP steps and get you heading in the right direction.

Schedule your free Key Metrics review!