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Date
2011-12-21
Event
Payment Standardization and Risk Adjustment
Topic
Value-Based Payment Modifier – Physician Feedback Program

Description

Under the Physician Feedback Program, CMS provides confidential feedback reports to physicians and physician group practices about the resource use and quality of care they provide to their Medicare patients. Section 3007 of the Affordable Care Act requires CMS to apply a Value Modifier, which compares the quality of care furnished to the cost of that care, to physician payment rates under the MPFS starting with specific physicians and physician groups in 2015 and expanding to all physicians by 2017.

During this National Provider Call, CMS subject matter experts discussed how and why per capita cost measures are adjusted under these programs. This call provided an opportunity to: (1) have a public dialogue about our methodology, (2) obtain stakeholder input, and (3) discuss ways to further improve these cost adjustment processes.

Target Audience: Physicians, specialty medical society representatives and other interested parties

Agenda:

  • Opening Comments and Background
    • Brief overview of the QRUR and Value Modifier Programs
    • Timelines
  • Presentation: Standardizing cost data to make fair comparisons
    • General background, purpose, and use
    • Basics of how it applies to Physician Feedback Program/Value Modifier
  • Comments and questions from participants
  • Presentations: Adjusting cost data for beneficiary health status
    • Background, development, and purpose of the CMS-HCC risk adjustment methodology
    • Application of the risk adjustment to the Physician Feedback program/Value modifier
  • Comments and questions from participants
  • Closing and next steps

For More Information:

For more information on the Physician Feedback Program and the Value-Based Payment Modifier, please visit: http://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/PhysicianFeedbackProgram/index.html