Quality Payment Program (QPP)

Visit the Quality Payment Program (QPP) website at http://qpp.cms.gov.

What is the Quality Payment Program?

The Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) made three important changes to how Medicare pays those who give care to Medicare beneficiaries. These changes included:

  • Ending the Sustainable Growth Rate (SGR) formula for determining Medicare payments for health care providers’ services.
  • Making a new framework for rewarding health care providers for giving better care not more just more care.
  • Combining our existing quality reporting programs (PQRS, Meaningful Use, and the Value Based Payment Modifier) into one new system

Choose from 2 different paths:

Merit-based Incentive Payment System (MIPS) Advanced Alternate Payment Models (APMs)


When does the Quality Payment Program start?

The program begins January 1, 2017.

If you are not ready for a full year on January 1, 2017, you can  choose to start anytime between January 1 and October 2, 2017. (However, keep in mind, a successful full year participation will receive a higher payment adjustment.)


What is the attestation deadline for the 2017 performance year?

Whenever you choose to start, you’ll need to send in your performance data by March 31, 2018.


When will I receive a payment adjustment based on the 2017 performance year?

The first payment adjustments based on 2017 performance go into effect on January 1, 2019 and your 2019 Medicare payments will be adjusted up, down, or not at all. The amount of your payment adjustment will vary depending on the data you submit by March 31, 2018.

NOTE: If you DO NOT send any data by March 31, 2018, you will receive a negative 4% payment adjustment to your Medicare payments in calendar year 2019. And the penalty will increase each subsequent year: 5% in 2020, 7% in 2021 and 9% in 2022.