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CMS Quality Programs aim to enhance healthcare delivery by promoting high standards of care, improving patient outcomes, and encouraging cost-effective practices. Access tools and guidance to support participation, compliance, and performance improvement.

Quality Payment Program

With the enactment of the Medicare Access and CHIP Reauthorization Act (MACRA), the Medicare Sustainable Growth Rate formula was repealed and replaced in January 2017 with the Quality Payment Program (QPP). Eligible clinicians can participate in the QPP via one of two pathways: the Merit-Based Incentive Payment System (MIPS) or Alternative Payment Models (APMs). Physician payment for Medicare being driven by MIPS and APMs started in 2019 with 2017 reporting, and continues.

CMS Quality Legacy Programs

As of January 2017, the Physician Quality Reporting System (PQRS), the Value Based Payment Modifier and the EHR Incentive Program have each been replaced by the QPP as part of MACRA.

The  allows patients to find and choose a physician enrolled in Medicare. The website lists physician details including: practice addresses, specialties, Medicare assignment status, quality program participation, gender, medical school, and residency, associated groups and hospital affiliation.  

Ambulatory Surgical Center Quality Reporting Program (ASCQR)

The  program promotes higher quality care by requiring Medicare-certified ASCs to report on quality measures in order to avoid future Medicare reductions. ASCs that do not meet reporting requirements may be subject to a 2% payment reduction.