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2016 Physician Quality Reporting System Experience Report and the 2018 Value Modifier Experience Report Are Now Available

August 21, 2018

McDermott+Consulting

2016 Physician Quality Reporting System (PQRS) Reporting Experience Report

The 2016 Physician Quality Reporting System (PQRS) Reporting Experience Report is now available. 2016 PQRS reporting impacts 2018 payments under the Medicare Physician Fee Schedule (PFS). Of all clinicians that were eligible to participate in 2016, 31% (435,111) will receive a payment adjustment of -2% in 2018. Almost 85% of those subject to the adjustment did not attempt to participate in the program (that is, did not submit any data).

This report provides historical trends on eligibility, participation, payment incentives and adjustments, and measure performance broken down by specialty and state. It gives a snapshot of this program and shows who participated, including the type of eligible clinician and their specialty, as well as what methods they used to participate. The full 2016 PQRS Experience Report is available here.

2018 Value-Based Payment Modifier Program Experience Report

The 2018 Value-Based Payment Modifier Program Experience Report highlights characteristics of the practices subject to the Value Modifier in 2018 and compares program results across 2015, 2016, 2017, and 2018. In 2018, the Value Modifier applies upward, downward, and neutral payment adjustments at the practice level to Medicare PFS payments to physicians, nurse practitioners, physician assistants, clinical nurse specialists, and certified registered nurse anesthetists based their performance in 2016.

The full 2018 Value Modifier Experience Report and the factsheet on the 2018 Value Modifier results is available here.

These are the final Experience Reports for the PQRS and Value Modifier programs, as both programs sunset December 31, 2018.  Many elements of PQRS transitioned to the Quality Performance Category of the Merit-based Incentive Payment System.

 


For more information on the Quality Payment Program visit the McDermottPlus Payment Innovation Resource Center or contact Sheila Madhani at 202-204-1459, smadhani@mcdermottplus.com.

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