January 2019
Value-Based Care
Over the past several years, Medicare and commercial payers have moved toward value-based payment, shifting from payment solely based on the volume of care, such as traditional fee-for-service, to payment more closely related to outcomes of care. Value-based payment models use measures of quality and cost to determine payment for providers. Ensuring high quality of care while controlling cost is key to success in these models. Physical therapists need to be able to use quality measures to articulate the value they bring to the health care system, given that in the near future payment for services will depend on quality-measure performance.
A variety of programs have been developed to address value-based care payment, including the Medicare Quality Payment Program (QPP).
Starting in 2019, the Centers for Medicare and Medicaid Services (CMS) is requiring certain PTs and physical therapy practices to participate in QPP through the Merit-based Incentive Payment System (MIPS) OR Advanced Alternative Payment Models (APMs).
Quality Payment Program (QPP)Certain PTs in private practice will be required to participate in the QPP program through either MIPS or Advanced APMs beginning January 2019. Additionally, CMS has proposed to allow certain other PTs and physical therapy practices to opt in to the program, enabling them to earn incentive payments and to prepare for participation in Advanced APMs. Learn more. |
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Merit-based Incentive Payment Systems (MIPS)Eligible clinicians will be subject to a performance-based payment adjustment through MIPS. Learn more. |
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Advanced Alternative Payment Models (APMs)Clinicians may earn a Medicare incentive payment if they participate successfully in an Advanced APM or innovative payment model. Learn more. |
Over the past several years, Medicare and commercial payers have moved toward value-based payment, shifting from solely payment based on the volume or care, such as traditional fee-for-service, to payment more closely related to outcomes of care. Value-based payment models use measures of quality and cost to determine payment for providers. Ensuring high quality of care while controlling cost is key to success in these models. Physical therapists need to be able to use quality measures to articulate the value they bring to the health care system, given than in the near future reimbursement of services will depend on quality-measure performance.
For more on Value Based Care visit: http://www.apta.org/VBC/
Got questions on MIPS?
The Merit-based Incentive Payment System (MIPS) is now in effect for many physical therapists. At a recent live webinar, APTA answered some of our members' most pressing questions. (In case you missed it, you can listen to the recorded webinar in its entirety.)
We've recapped some popular questions here. Not finding the question you need answered? You can email advocacy@apta.org. APTA members can also post questions, and review answers to other member questions on the Medicare MIPS Discussion Board on the Medicare Quality Reporting Hub.
For more: http://www.apta.org/Blogs/PTTransforms/2018/1/9/CSMPreviewMIPS/
