Medicare Incentive Payment Programs
The Centers for Medicare and Medicair Services (CMS) has three four incentive payment programs from which physicians and other eligigble professionals can boost their payments. The Programs include the Electronic Health Record (EHR) Initiative, the E-Prescribing (eRx) Incentive Program, the Physician Quality reporting System (PQRS), and the Value-Based Payment Modifier. More information about each program can be found below.
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eRx Incentive Payments
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PQRS Incentive Payments
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Value-Based Payments
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The Medicare and Medicaid EHR Incentive Programs will provide incentive payments to eligible medical care providers as they adopt, implement, upgrade or demonstrate meaningful use of certified EHR technology. |
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The Electronic Prescribing (eRx) Incentive Program is a reporting program that provides incentive payments and payment adjustments to encourage electronic prescribing by medical care providers. |
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The Physician Quality Reporting System (PQRS) is a voluntary reporting program that provides an incentive payment to eligible individuals and practices who satisfactorily report data on quality measures for covered Physician Fee Schedule (PFS) services furnished to Medicare Part B Fee-for-Service (FFS) beneficiaries |
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Value-based payment models are focused on encouraging high value care delivery through greater integration, improved care coordination, and a focus on patient safety. These models are designed to foster a culture of accountability that rewards high quality and cost effective care. |
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Over the next several years, Medicare is required by the Affordable Care Act to provide confidential feedback reports to physicians on their quality and cost of care. These feedback reports will lay the groundwork for implementation of a Value Based Payment Modifier that will pay physicians' differentially based on their performance beginning in 2015. It is likely that some of the information included in the confidential feedback reports will eventually be made publicly available through Medicare's Physician Compare Website.
IDSA and other physician groups believe that the performance data underpinning the physician feedback reports and the Value-Based Payment Modifier must be based on clinically valid and risk-adjusted measures that attribute care to the appropriate physicians. The Society also has expressed concern that differential payments under the Value-Based Payment modifier will be implemented in 2015 concurrently with separate payment penalties under the Physician Quality Reporting System.
IDSA Resources on Value-Based Payment models
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