Quality Reporting: The SGR Is Finally Gone But MIPS Takes Its Place

Why This Topic Matters

The article matters because it explains how Medicare physician payment is being reshaped by quality reporting programs and highlights the reporting burdens and payment consequences that can affect individual providers and groups. For emergency medicine and other specialties with limited measure availability, the article helps readers understand why these programs require careful monitoring and preparation.

Article Sections

1. Meet the Merit-Based Incentive Program

   Introduces the new Medicare payment framework and the quality-related performance categories associated with it. Also places the change in context alongside the earlier physician payment system.

2. Keep Current with Physician Quality Reporting System

   Reviews the reporting program that continues during the transition period and explains its relationship to future payment adjustments. Covers general reporting expectations and specialty-specific challenges.

3. Welcome New Emergency Medicine Cluster for 2016

   Describes the emergency medicine reporting cluster created for the reporting year and its role in the interim quality reporting structure. Focuses on how CMS adapted reporting options for this specialty.

4. Cross Cutting Measure 317 Is Still Available

   Discusses the availability of a cross-cutting reporting option for emergency medicine and the surrounding measure context. Highlights the broader reporting environment for physicians using this measure category.

5. CMS Uses a Multi-Step Process For Scoring PQRS Reporting

   Explains the validation framework CMS uses to evaluate reporting when fewer measures are available. Includes the general process used to assess measure applicability and minimum reporting thresholds.

6. Where Does The MAV Fit In?

   Clarifies the role of measure applicability validation within the reporting and penalty-avoidance process. Focuses on how the validation concept fits into the overall program structure.

7. Take a Closer Look at the 2016 Value-Based Payment Modifier

   Summarizes the separate value-based modifier program and its relationship to quality and cost performance. Also notes how it applies at the organizational level and its broader phase-in timeline.

8. Incentive Percentages for Groups of 10 or More Providers

   Presents the article’s closing discussion of group-level incentive structure. Covers the general idea of how reporting participation and group size affect potential payment outcomes.