Main

281.440.0101

Schedule an appointment

281.453.2050

Quality Payment Program

The Quality Payment Program, established by the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA), is a quality payment incentive program for physicians and other eligible clinicians, which rewards value and outcomes. The goal of the program is to create a simpler, sustainable Medicare program.  CMS anticipates the Quality Payment Program's reach will influence decisions for private, state and local payment systems.  The Quality Payment Program provides new opportunities to improve care delivery by supporting and rewarding clinicians as they find new ways to engage patients, families and caregivers and to improve care coordination and population health management. Better care coordination can mean giving patients more quality time with their physician, expanding ways patients are able to communicate with the team of clinicians caring for them or engaging patients and families more deeply in decision-making.  These activities ultimately lead to the delivery of higher-value care.  

Stakeholder feedback is a very important part of the Quality Payment Program. As CMS moves into the second year, referred to as “The Quality Payment Program Year 2,” they have been listening to feedback and using it to ensure that: 

  • The program’s measures and activities are meaningful.
  • Clinician burden is minimized.
  • Care coordination is improved.
  • Clinicians have a clear way to participate in Advanced APMs. 

In Year 2, CMS is keeping much of the flexibility from the transition year to assist clinicians in getting ready for Year 3. Since January 1, 2017, they’ve worked with more than 100 stakeholder organizations and over 47,000 people to get the word out about the Quality Payment Program, get feedback, and help make it easier for physicians and providers to participate. They’ve also reviewed over 1,200 stakeholder comments and finalized many of the proposed policies from the calendar year (CY) 2018 Quality Payment Program proposed rule. Because CMS wants to continue to receive feedback, this is a final rule with comment period. 

The Quality Payment Program makes major changes to how Medicare pays clinicians. They’ve heard challenges and concerns from stakeholders, so they promise to keep: 

  • Going slow while preparing clinicians for full implementation in year 3.
  • Providing more flexibility to help reduce the burden.
  • Offering new incentives for participation. 

The goal, very simply: "Patients Over Paperwork". CMS recently launched the “Patients Over Paperwork” Initiative, a cross-cutting, collaborative process that evaluates and streamlines regulations with a goal to reduce unnecessary burden, increase efficiencies, and improve the beneficiary experience. This effort emphasizes a commitment to removing regulatory obstacles that get in the way of providers spending time with patients. CMS promises to continue looking for ways to reduce the regulatory burden and simplify the program.

Despite 2017 being a "transition year", Digestive & Liver Disease Consultants, PA and it's highly dedicated team, made the conscious decision to dive head first into full compliance with the guidelines implemented in the Quality Payment Program Year 1. 

As a group, we've prided ourselves in "leading the pack", participating in CMS' PQRS and Meaningful Use programs prior to the Quality Payment Program / MACRA.  Each program came with it's own set of unique challenges, yet overall, the quality measures provide invaluable information, not only to CMS, but to the clinician.  We are continuing to improve quality outcomes to further enhance our patient-centered practice and focus on informed and coordinated care for individuals in our community.

Guru N Reddy, MD, FACP, FACG, FASGE, AGAF
Diplomate, American Board of Internal Medicine & Gastroenterology