The Centers for Medicare and Medicaid Services (CMS) have implemented three clinician-level programs to promote improvements in the quality of care provided to beneficiaries. As the Medicare program continues to evolve into a pay-for-value system, it is important for providers to understand each of these programs and their associated requirements.

Electronic Health Record (EHR) Incentive Program

The federal government developed the Electronic Health Record (EHR) Incentive Program to encourage use of health information technology. Under the program, qualified physicians that demonstrate "meaningful use" of EHR technology and performance between 2011 and 2015 can receive bonus payments. Click here to learn more >>>

Value-Based Payment Modifier

The Value-Based Payment Modifier, or Value Modifier, provides bonus payments or penalties to physicians based on the quality and cost of care provided during a performance period. The 2015 Value Modifier is currently being applied to groups of 100 or more eligible professionals based on 2013 performance. The 2017 Value Modifier, which is based on 2015 performance, will be applied to all physicians, including solo practitioners. Click here to learn more >>>

Physician Quality Reporting System (PQRS)

The Physician Quality Reporting System (PQRS) collects data on the quality of care provided to Medicare beneficiaries based on clinician performance against selected quality measures. A -2 percent payment adjustment will be applied to Medicare Part B payments in 2018 for providers who do not satisfactorily report data on quality measures for covered professional services throughout the 2016 program year. Providers should review their options for PQRS reporting to ensure that they are utilizing the most efficient mechanism for their practice. Click here to learn more >>>

The ACC’s PINNACLE Registry is an accepted Qualified Clinical Data Registry individual reporting option for 2016 PQRS.

Core Quality Measure Collaborative Cardiovascular Measures

In 2015, the ACC participated in the Core Quality Measure Collaborative (CQMC), led by America’s Health Insurance Plans and the Centers for Medicare and Medicaid Services (CMS), to establish a set of measures intended for use across a broad spectrum of stakeholders including commercial health plans, consumers, and physicians. The measures are intended to increase alignment and ease the reporting burden of measures to public and private payers. Click here to learn more >>>