On October 14, 2016, the US Department of Health and Human Services (HHS) issued the final rule with comment period implementing the Quality Payment Program – a direct result of the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA). MACRA legislation ended the Sustainable Growth Rate formula, which threatened providers who participate in Medicare reimbursement with potential payment cliffs for 13 years.

The Quality Payment Program improves Medicare by prioritizing on quality health care that focuses on health and prevention. Providers who currently, participate in Medicare provide health care services to more than 55 million of the country’s most vulnerable patient population. The Quality Payment Program will reform Medicare payments for more than 600,000 providers across the US.

Providers can choose how to participate in the Quality Payment Program based on practice size, specialty, location, and patient population. Participation requires billing for more than $30,000 a year and provide annual care for a minimum of 100 Medicare patients. Providers include:

  • Physician
  • Physician assistant
  • Nurse practitioner
  • Clinical nurse specialist
  • Certified registered nurse anesthetist

The October 14th release has provided specific direction for providers, practices and organizations. To learn more access, the Quality Payment Program newly revised website to learn how to prepare for quality reporting between January – October, 2017.