On October 14, 2016, the Centers for Medicare and Medicaid Services (CMS) published a final rule implementing the Quality Payment Program. CMS also launched a Quality Payment Program website designed to help providers understand the Program and a Quality Payment Program Overview Fact Sheet, which is a terrific starting point for physicians interested in learning more. CAFP urges California family physicians to explore the CAFP QPP Playbook web pages, review the Fact Sheets and participate in CAFP’s upcoming educational activities to learn more about the Quality Payment Program. We want ALL California family physicians submitting data in 2017 and avoiding a payment penalty.
In the final rule, CMS created a more flexible schema wherein physicians who submit ANY data in 2017 can avoid a negative adjustment to their payment. Physicians who submit more data will get a positive payment adjustment. Five pacing options have been set for implementation. Here are the options for physicians; read here more detailed information:
- Test the Program
- Participate for Part of the Calendar Year
- Participate for the Full Calendar Year
- Participate in an Advanced Alternative Payment Model for 2017
- Do Not Participate in the Quality Payment Program and Take Payment Penalty
Most California family physicians will be in the MIPS track of the Quality Payment Program. Here are steps you can take NOW to prepare.
- Explore CMS’s Newly-Launched Quality Payment Program Website and the Quality Payment Program Overview Fact Sheet.
- Consider whether you are a MIPS-eligible clinician.
- Participate in a patient clinical data registry.
- Check your PQRS feedback reports and review the list of MIPS quality measures.
- Review the final rule’s list of Clinical Practice Improvement Activities (CPIAs).
- Contact your EHR vendor.
- Participate in CAFP Educational Programming, beginning with QPP101.
A starting point to gain familiarity with the law is to explore the Quality Payment Program website and review the Quality Payment Program Overview Fact Sheet. QPP 101 is ready for you now; QPP 201 will be launched later this year to assist you with all aspect of the process.
QPP for the small and rural practice physician
CAFP has just released the Small and Rural Practice Family Physicians’ Quality Payment Program primer ready for download now. The primer discusses how QPP affects solo, small and rural practice physicians and outlines readily available, FREE technical assistance.
Additionally, CAFP hosted a webinar, The Quality Payment Program Guidance for Small and Rural Practices, with health care and payment expert Leah Newkirk, JD and Health Services Advisory Group (HSAG) representative David Mittra. Slides from the webinar are available for download now!
CAFP advocates for higher payment for family physicians in California. Investment in primary care leads to improved quality of care, better patient health and lower health care costs overall. We also advocate for payment reform, to move our health care system from a fee-for-service model to a model that appropriately compensates physicians for high-value care. This means that family physicians should be paid for services, such as care management, that they have historically provided without pay. Read more about CAFP’s advocacy efforts on MACRA and payment reform.
We will regularly provide news updates on MACRA, payment reform and related topics. We have also included a series of links to blogs, useful tools and resources, and more.
Questions about the CAFP QPP Playbook? Contact Conrad Amenta, CAFP's Director of Health Policy.