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  • Value-Based Payment Modifier for Physicians

    Mandated by the Affordable Care Act, the Center for Medicare and Medicaid Services (CMS) will begin to apply a value modifier under the Medicare Physician Fee Schedule in 2015. Payment adjustments will be calculated by cost and quality data for physicians in groups of 100 or more eligible professionals who submit claims to Medicare under a single tax identification number. By 2017, all physicians who participate in fee-for-service Medicare will be impacted by the value modifier based off PQRS quality data.

    For more information on the Value-Based Payment Modifier, please read the Physician Feedback, Quality and Resource Use Reports (QRURs) and Value-Based Modifier Programs Medicare Learning Network (MLN) article (PDF) that provides background, provider actions, and overviews regarding the CMS quality programs. Additionally, please visit the CMS Value-Based Payment Modifier page for more information.

    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's concerns with the Value-Based Payment modifier and Physician Feedback Program can be viewed in the Physicians Fee Schedule Proposed Rule (PDF) and Physician Fee Schedule Final Rule (PDF) comment letters.

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