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HHS releases design of new Medicare physician payment system

The proposed rule enables physicians participating in Medicare to pursue payment under the Quality Payment Program.

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This week, the Department of Health and Human Services (HSS) issued a proposed rule to create a new Medicare physician payment system.

Last year Congress passed the Medicare Access and CHIP Reauthorization Act of 2015, which repealed the Medicare sustainable growth rate formula.

The proposed rule will implement a new Medicare physician payment system through a unified framework called the Quality Payment Program. The program includes two paths for physicians in Medicare:

  • The Merit-Based Incentive Payment System builds on the fee-for-service payment system and provides new opportunities for performance bonuses by overhauling EHR Meaningful Use, Value Modifier and PQRS reporting programs into one streamlined program.
  • Advanced Alternative Payment Models provide value-based payments for coordinated, high-quality care. Models include accountable care organizations, patient-centered medical homes and bundled payments.
  • Visit the AOA’s Medicare Payment: The Road Ahead for more information and key milestones in the implementation process.

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