Results from the KPMG-AMA Survey
January 1, 2017 marked the beginning of the first performance year of the Quality Payment Program (QPP) created by the Medicare Access and CHIP Reauthorization Act or 2015 (MACRA). Beginning in 2019, the QPP will adjust payment rates for physicians and other eligible health care professionals for participation in 2017 under one of two payment tracks: (1) a payment system with incentives or penalties for reporting and meeting certain quality measures, demonstrating use of a certified electronic health record and other measures through the Merit-Based Incentive Payment System (MIPS); or, (2) a 5 percent lump sum bonus payment if the physician has a threshold portion of their revenue or patients in a qualifying Advanced Alternative Payment Model (Advanced APM). In order to help ease the transition to this new payment system, the Centers for Medicare and Medicaid Services (CMS) created a flexible "pick your pace" reporting option for physicians. Additionally, CMS rules are likely to exclude nearly two-thirds of all clinicians from MIPS reporting in 2017 (a large portion based on low volume thresholds or Advanced APM participation; Advanced APMs are also excluded from MIPS). Under the 2018 performace year proposed rule, even more physicians would be excluded in performace year 2018 as a result of increasing the low volume threshold.
There remains a signficant QPP knowledge gap among physicians.