Physician and Clinician Value Policy
The HQC closely follows the development and implementation of policies to advance value-based payment for Medicare Part B physician and clinician services. During the deliberations of the Affordable Care Act, the HQC urged Congress to include programs to link payment to the quality and cost of care provided. The result was the inclusion of Section 3007, the Physician Value Based Payment Modifier.
Legislative and Regulatory work
The Physician Value Modifier tied a percent of Medicare Part B payment for an individual or group of physician's care to measures of cost and quality. The beginning of the program built on and extended the Physician Quality Reporting System (PQRS) from a pay for reporting program to pay for performance. The HQC closely followed the implementation of this program and provided comprehensive, detailed comments to the Centers for Medicare and Medicaid Services (CMS).
The enactment of the Medicare Access and CHIP Reauthorization Act (MACRA) in 2015 sunsetted the Value Modifier Program, and replaced with Quality Payment Program (QPP). The QPP has two payment "tracks": the Merit-based Incentive Payment System (MIPS) and advanced Alternative Payment Models (APMs). As a policy priority, under the goal of moving the nation forward to value-based payment and care delivery, the HQC continues to urge CMS to focus on measures of clinical outcomes, invest in new APM options, and improving existing models. Learn more about the Quality Payment Program.