medical professionals to report quality information to Medicare. The quality measures can be reported as individual provider or a group practice.
In 2016 PQRS transitioned to the Merit-based Incentive Payment System (MIPS) & Alternative Payment Model (APM) under the Quality Payment Program. The MACRA Act of 2015 replaced PQRS, Value Based Payment Modifier & the Medicare Health Record (EHR) Incentive Program with a single program called the Quality Payment Program.
MERIT-BASED PAYMENT SYSTEM (MIPS)
Provides performance based payment adjustments for services provided to Medicare patients. Performance is measured in 4 areas - Quality, Improvement Activities, Promoting Interoperability & Cost . The final score from these measures determine the payment adjustment that will be made.
ALTERNATIVE PAYMENT MODEL (APM)
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A customized payment approach that was designed to provide incentives to providers who are providing high quality care
It can apply to a specific clinical condition or episode of care. Providers may earn a 5% incentive for achieving threshold level of payments or patients under in the Advanced APM Track of the Quality Payment Program.