Advocacy in Action – Reporting One Measure Saves You Money

Carter L. Alleman, J.D.

The Quality Payment Program (QPP) became live on January 1, 2017. This year serves as a transition year for doctors to participate in the QPP, during which the only physicians who will experience a -4 percent payment penalty in 2019 are those who choose not to report any performance data. Physicians can avoid the payment penalty in 2019 by reporting for one patient on one quality measure, one improvement activity, or the 4 required Advancing Care Information (ACI) measures in 2017. Physicians who wish to possibly qualify for a positive payment adjustment must report more than the minimum one patient for one quality measure, improvement activity or the 4 required ACI measures.

Centers for Medicare & Medicaid Services (CMS) created a pick your own pace program to encourage data submission whereby any data submission may result in a positive net payment adjustment.

First Option: Test the Quality Payment Program.

With this option, as long as you submit some data to the Quality Payment Program, including data from after January 1, 2017, you will avoid a negative payment adjustment. This first option is designed to ensure that your system is working and that you are prepared for broader participation in 2018 and 2019 as you learn more.

Second Option: Participate for part of the calendar year.

You may choose to submit Quality Payment Program information for a reduced number of days. This means your first performance period could begin later than January 1, 2017 and your practice could still qualify for a small positive payment adjustment. For example, if you submit information for part of the calendar year for quality measures, how your practice uses technology, and what improvement activities your practice is undertaking, you could qualify for a small positive payment adjustment. You could select from the list of quality measures and improvement activities available under the Quality Payment Program.

If you do NOT submit any data, you will receive an automatic negative 4% payment adjustment for the 2019 payment cycle.

Current CMS Resources

CMS’ Quality Payment Program Website
CMS’ Small Practice Fact Sheet