Medicare FFS Physician Feedback Program/Value-Based Payment Modifier

Value Modifier Program Transitioned to the Quality Payment Program

The Merit-based Incentive Payment System (MIPS) under the Quality Payment Program  replaced the Physician Feedback/Value-Based Payment Modifier (Value Modifier) program on January 1, 2019.  Calendar Year 2018 (2018) was the final payment adjustment period under the Value Modifier program based on performance in Calendar Year 2016.

Background on the Physician Feedback/Value Modifier Program

The Value Modifier provided for differential payment under the Medicare Physician Fee Schedule (PFS) based on the quality of care furnished to Medicare beneficiaries compared to the cost of care during a performance period. The Value Modifier was an adjustment made to Medicare payments for items and services under the Medicare PFS. Section 3007 of the Affordable Care Act mandated that the Value Modifier be applied to specific physicians and groups of physicians the Secretary determines appropriate starting January 1, 2015 and to all physicians and groups of physicians by January 1, 2017. Beginning January 1, 2018, the Value Modifier applied to all physicians, physician assistants, nurse practitioners, clinical nurse specialists, and certified registered nurse anesthetists. Both cost and quality data were included in calculating the Value Modifier.

The Physician Feedback Program provided comparative performance information to solo practitioners and medical practice groups, as part of Medicare’s efforts to improve the quality and efficiency of medical care furnished to Medicare beneficiaries. Providing clinically meaningful and actionable information to solo practitioners and medical practice groups so they can improve the care they deliver contributes to the building of a health care system that delivers better care, spends health care dollars more wisely, and results in healthier people. The Physician Feedback Program was initiated under section 131 of the Medicare Improvements for Patients and Providers Act of 2008 (MIPPA), and was expanded by section 3003 of the Affordable Care Act of 2010.

Calendar Year 2015 was the first payment adjustment period under the Value Modifier based on performance in Calendar Year 2013. Calendar Year 2018 was the final payment adjustment period under the Value Modifier based on performance in Calendar Year 2016. Therefore, the Quality and Resource Use Reports (QRURs) that provided feedback to solo practitioners and medical group practices are no longer available after December 31, 2018. 

Read the Frequently asked questions document (PDF) for more information about the Quality and Resource Use Reports and the Value Modifier Program.

Learn more about the Quality Payment Program:

Quality Payment Program Service Center (Monday – Friday; 8:00 A.M. – 8:00 P.M. Eastern Time)

 

Page Last Modified:
07/02/2021 01:39 PM