CMS Releases 2015 Value Modifier Results

The Centers for Medicare and Medicaid Services has issued the results for group practices of 100 or more eligible professionals (EPs) subject to the calendar year (CY) 2015 Value-Based Payment Modifier (VM) based on CY 2013 performance. For CY 2015, 127 of 691 eligible groups exercised the option to have their VM calculated using the quality-tiering methodology where they were eligible for an upward or downward payment adjustment based on performance. Of the 127 groups opting in, 106 had sufficient data to calculate a cost and quality composite for quality tiering: 81 practices received no additional adjustment, 14 practices qualified for an upward adjustment, and 11 practices received a downward adjustment. Payment adjustments ranged from -1 percent to an incentive of two times the "payment adjustment factor," which is determined by the amount of funds derived from the application of downward adjustments. For CY 2015, the payment adjustment factor is 4.89 percent. Of the 14 practices receiving an upward adjustment, all qualified for the 4.89 percent (1x) adjustment.

Keywords: Centers for Medicare and Medicaid Services (U.S.), Costs and Cost Analysis, Financial Management, Group Practice

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