{"id":6709,"date":"2026-07-03T14:44:07","date_gmt":"2026-07-03T14:44:07","guid":{"rendered":"https:\/\/medibillmd.com\/blog\/?p=6709"},"modified":"2026-07-03T14:44:08","modified_gmt":"2026-07-03T14:44:08","slug":"quality-payment-program","status":"publish","type":"post","link":"https:\/\/medibillmd.com\/blog\/quality-payment-program\/","title":{"rendered":"What is the Quality Payment Program (QPP)?"},"content":{"rendered":"\n<p class=\"wp-block-paragraph\">Improving care quality and patient outcomes has become a central objective of the U.S. healthcare system. Historically, Medicare reimbursement relied primarily on fee-for-service (FFS) payments. Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) shifted the focus toward quality, outcomes, and value-based care.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">The <a href=\"https:\/\/qpp.cms.gov\/\" target=\"_blank\" rel=\"noreferrer noopener nofollow\">Quality Payment Program (QPP)<\/a> was introduced as Medicare&#8217;s value-based payment framework for eligible clinicians who bill Medicare Part B services.\u00a0<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">The program was established under the <a href=\"https:\/\/www.aapc.com\/resources\/what-is-macra?srsltid=AfmBOoo6B0zuD-0_mPEOEGaoT_fsQ_Ze0J0l6RwmJI6FJy-AHIJ9tgpj\" target=\"_blank\" rel=\"noreferrer noopener nofollow\">MACRA<\/a> of 2015 and replaced the Sustainable Growth Rate (SGR) formula.\u00a0<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">QPP primarily applies to clinicians who meet the Centers for Medicare &amp; Medicaid Services (CMS\u2019s) participation requirements. Under this program, eligible clinicians are rewarded for delivering high-quality, cost-effective care.&nbsp;<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">The Quality Payment Program encourages providers to focus on quality outcomes rather than service volume alone. As a result, CMS QPP allows clinicians to receive incentives for better care or penalties based on their performance.<\/p>\n\n\n\t\t\t\t<div class=\"wp-block-uagb-table-of-contents uagb-toc__align-left uagb-toc__columns-1 uagb-toc__collapse uagb-block-11bf88ec      \"\n\t\t\t\t\tdata-scroll= \"1\"\n\t\t\t\t\tdata-offset= \"30\"\n\t\t\t\t\tstyle=\"\"\n\t\t\t\t>\n\t\t\t\t<div class=\"uagb-toc__wrap\">\n\t\t\t\t\t\t<div class=\"uagb-toc__title\">\n\t\t\t\t\t\t\tTable Of Contents\t\t\t\t\t\t\t\t\t\t\t\t\t<svg xmlns=\"https:\/\/www.w3.org\/2000\/svg\" viewBox= \"0 0 384 512\"><path d=\"M192 384c-8.188 0-16.38-3.125-22.62-9.375l-160-160c-12.5-12.5-12.5-32.75 0-45.25s32.75-12.5 45.25 0L192 306.8l137.4-137.4c12.5-12.5 32.75-12.5 45.25 0s12.5 32.75 0 45.25l-160 160C208.4 380.9 200.2 384 192 384z\"><\/path><\/svg>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<div class=\"uagb-toc__list-wrap \">\n\t\t\t\t\t\t<ol class=\"uagb-toc__list\"><li class=\"uagb-toc__list\"><a href=\"#cms-quality-payment-program-models\" class=\"uagb-toc-link__trigger\">CMS Quality Payment Program Models<\/a><ul class=\"uagb-toc__list\"><li class=\"uagb-toc__list\"><a href=\"#merit-based-incentive-payment-system-mips\" class=\"uagb-toc-link__trigger\">Merit-Based Incentive Payment System (MIPS)<\/a><li class=\"uagb-toc__list\"><li class=\"uagb-toc__list\"><a href=\"#alternative-payment-models-apm\" class=\"uagb-toc-link__trigger\">Alternative Payment Models (APM)<\/a><\/li><\/ul><\/li><li class=\"uagb-toc__list\"><a href=\"#tips-for-streamlining-qpp-for-healthcare-practices\" class=\"uagb-toc-link__trigger\">Tips for Streamlining QPP for Healthcare Practices<\/a><ul class=\"uagb-toc__list\"><li class=\"uagb-toc__list\"><a href=\"#verify-qpp-eligibility-early\" class=\"uagb-toc-link__trigger\">Verify QPP Eligibility Early<\/a><li class=\"uagb-toc__list\"><li class=\"uagb-toc__list\"><a href=\"#select-mips-measures-strategically\" class=\"uagb-toc-link__trigger\">Select MIPS Measures Strategically<\/a><li class=\"uagb-toc__list\"><li class=\"uagb-toc__list\"><a href=\"#monitor-cost-performance\" class=\"uagb-toc-link__trigger\">Monitor Cost Performance<\/a><li class=\"uagb-toc__list\"><li class=\"uagb-toc__list\"><a href=\"#optimize-pi-workflows-early\" class=\"uagb-toc-link__trigger\">Optimize PI Workflows Early<\/a><li class=\"uagb-toc__list\"><li class=\"uagb-toc__list\"><a href=\"#strengthen-clinical-documentation\" class=\"uagb-toc-link__trigger\">Strengthen Clinical Documentation<\/a><li class=\"uagb-toc__list\"><li class=\"uagb-toc__list\"><a href=\"#perform-internal-audits\" class=\"uagb-toc-link__trigger\">Perform Internal Audits<\/a><\/li><\/ul><\/li><\/ul><\/li><li class=\"uagb-toc__list\"><a href=\"#wrapping-it-up\" class=\"uagb-toc-link__trigger\">Wrapping It Up<\/a><\/ul><\/ul><\/ol>\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\n\n\n<div style=\"height:30px\" aria-hidden=\"true\" class=\"wp-block-spacer\"><\/div>\n\n\n\n<h2 class=\"wp-block-heading\"><strong>CMS Quality Payment Program<\/strong><strong> Models<\/strong><\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">Healthacre providers participate in the <a href=\"https:\/\/www.cms.gov\/files\/document\/qpp-clinician-champion-fact-sheet-2018-05-15pdf\" target=\"_blank\" rel=\"noreferrer noopener nofollow\">Quality Payment Program<\/a> through two pathways:<\/p>\n\n\n\n<ol class=\"wp-block-list\">\n<li>Merit-Based Incentive Payment System (MIPS)\u00a0<\/li>\n\n\n\n<li>Advanced Alternative Payment Models (Advanced APMs).\u00a0<\/li>\n<\/ol>\n\n\n\n<h3 class=\"wp-block-heading\"><strong>Merit-Based Incentive Payment System (MIPS)<\/strong><\/h3>\n\n\n\n<p class=\"wp-block-paragraph\">Under the <a href=\"https:\/\/medibillmd.com\/blog\/understanding-mips\/\" target=\"_blank\" rel=\"noreferrer noopener nofollow\"><strong>MIPS payment system<\/strong><\/a>, clinicians are evaluated across four performance categories. As a result, these clinicians can receive a positive, neutral, or negative payment adjustment based on their <a href=\"https:\/\/qpp.cms.gov\/get-started\/what-is-mips\/final-score\" rel=\"nofollow noopener\" target=\"_blank\">MIPS score<\/a>.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">MIPS payment adjustments are applied to Medicare Part B covered professional services reimbursed under the <a href=\"https:\/\/www.cms.gov\/medicare\/payment\/fee-schedules\/physician\" target=\"_blank\" rel=\"noreferrer noopener nofollow\">Medicare Physician Fee Schedule (PFS)<\/a>. The evaluation MIPS categories include:<\/p>\n\n\n\n<figure class=\"wp-block-table\"><table><thead><tr><th class=\"has-text-align-center\" data-align=\"center\"><strong>MIPS Category<\/strong><\/th><th class=\"has-text-align-center\" data-align=\"center\"><strong>What It Assesses<\/strong><\/th><th class=\"has-text-align-center\" data-align=\"center\"><strong>Weightage<\/strong><\/th><\/tr><\/thead><tbody><tr><td class=\"has-text-align-center\" data-align=\"center\"><strong>Cost<\/strong><\/td><td class=\"has-text-align-center\" data-align=\"center\">Evaluates the cost of the care you provide to your Medicare patients based on your Medicare claims.&nbsp;<\/td><td class=\"has-text-align-center\" data-align=\"center\">30%<\/td><\/tr><tr><td class=\"has-text-align-center\" data-align=\"center\"><strong>Quality<\/strong><\/td><td class=\"has-text-align-center\" data-align=\"center\">Evaluates the quality of care you deliver based on measures of performance.&nbsp;<\/td><td class=\"has-text-align-center\" data-align=\"center\">30%<\/td><\/tr><tr><td class=\"has-text-align-center\" data-align=\"center\"><strong>Promoting Interoperability (PI)<\/strong><\/td><td class=\"has-text-align-center\" data-align=\"center\">Evaluates your promotion of patient engagement and electronic exchange of health information using certified electronic health record technology (CEHRT).&nbsp;<\/td><td class=\"has-text-align-center\" data-align=\"center\">25%<\/td><\/tr><tr><td class=\"has-text-align-center\" data-align=\"center\"><strong>Improvement Activities (IA)<\/strong><\/td><td class=\"has-text-align-center\" data-align=\"center\">Evaluates your participation in activities that improve clinical practices and support patient engagement.&nbsp;<\/td><td class=\"has-text-align-center\" data-align=\"center\">15%<\/td><\/tr><\/tbody><\/table><\/figure>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Note<\/strong>: MIPS payment adjustments are generally applied two years after the applicable performance year.<\/p>\n\n\n\n<h3 class=\"wp-block-heading\"><strong>Alternative Payment Models (APM)<\/strong><\/h3>\n\n\n\n<p class=\"wp-block-paragraph\">In APMs, clinicians are accountable for the cost and quality of services using a structured payment model. Examples include bundled payment arrangements and <a href=\"https:\/\/www.cms.gov\/priorities-innovation-key-concepts-accountable-care-accountable-care-organizations\" target=\"_blank\" rel=\"noreferrer noopener nofollow\">Accountable Care Organizations (ACOs)<\/a>.\u00a0<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">APMs can either be MIPS APMs, allowing participants to report through the APM Performance Pathway (APP). As a result, the participants receive MIPS payment adjustments.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Advanced APM participants, or the ones who have acquired a Qualifying APM Participant (QP) status, enjoy the following benefits:<\/p>\n\n\n\n<ol class=\"wp-block-list\">\n<li>Exclusion from MIPS reporting requirements<\/li>\n\n\n\n<li>Provision of favorable payment updates and other incentives under current Medicare payment policies.<\/li>\n<\/ol>\n\n\n\n<h2 class=\"wp-block-heading\"><strong>Tips for Streamlining <\/strong><strong>QPP <\/strong><strong>for Healthcare Practices<\/strong><\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">Streamlining the Quality Payment Program for healthcare practices can be a serious challenge. Fortunately, the following tips help healthcare practices get the best results:<\/p>\n\n\n\n<h3 class=\"wp-block-heading\"><strong>Verify <\/strong><strong>QPP <\/strong><strong>Eligibility Early<\/strong><\/h3>\n\n\n\n<p class=\"wp-block-paragraph\">Quality Payment Program requirements and obligations may vary based on the following factors:<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Participation track<\/li>\n\n\n\n<li>Clinician type<\/li>\n\n\n\n<li>Low-volume threshold eligibility<\/li>\n<\/ul>\n\n\n\n<p class=\"wp-block-paragraph\">However, practices should review the clinician participation status before the performance year. Additionally, practices should review the eligibility and Advanced APM participation status.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">You can achieve this quickly with the CMS QPP Participation Status Tool. Performing an early verification ensures workflow configuration, accurate reporting preparation, and documentation planning.&nbsp;<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Thus, organizations can avoid compliance challenges and errors in reporting after performance data collection has already started.<\/p>\n\n\n\n<h3 class=\"wp-block-heading\"><strong>Select MIPS Measures Strategically<\/strong><\/h3>\n\n\n\n<p class=\"wp-block-paragraph\">Merit-based Incentive Payment System scoring outcomes can be deeply influenced by the measures selected. QPP measures should be chosen only after a practice considers the following:<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Specialty-specific benchmarks<\/li>\n\n\n\n<li>Historical performance trends<\/li>\n\n\n\n<li>Clinical capabilities\u00a0<\/li>\n<\/ul>\n\n\n\n<p class=\"wp-block-paragraph\">More importantly, default EHR measures can negatively affect reporting effectiveness, which is why practices should choose carefully. The right metrics can directly contribute to improved overall MIPS scores.<\/p>\n\n\n\n<h3 class=\"wp-block-heading\"><strong>Monitor Cost Performance<\/strong><\/h3>\n\n\n\n<p class=\"wp-block-paragraph\">Did you know that CMS calculates the MIPS Cost category directly? This is done through claims data, but practices should actively monitor cost performance.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">It can reveal:<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Problematic utilization patterns<\/li>\n\n\n\n<li>Total per capita cost trends<\/li>\n\n\n\n<li>Opportunities to improve Medicare Spend per Beneficiary (MSPB) performance<\/li>\n<\/ul>\n\n\n\n<p class=\"wp-block-paragraph\">This information can then be used for further system optimization and to ensure the practice provides value-based services only.<\/p>\n\n\n\n<h3 class=\"wp-block-heading\"><strong>Optimize PI Workflows Early<\/strong><\/h3>\n\n\n\n<p class=\"wp-block-paragraph\">The Promoting Interoperability category depends on ongoing workflow execution. Therefore,&nbsp; if a practice skips requirements, it may not be fully recovered later during reporting.&nbsp;<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Practices should review their current EHR configurations and validate CEHRT functionality. Additionally, we recommend implementing compliant workflows prior to the performance year for accurate PI reporting.&nbsp;<\/p>\n\n\n\n<h3 class=\"wp-block-heading\"><strong>Strengthen Clinical Documentation<\/strong><\/h3>\n\n\n\n<p class=\"wp-block-paragraph\">Accurate documentation strengthens the quality of your reporting and risk adjustment. Similarly, it also optimizes the practice\u2019s cost performance. It is necessary to document the patient\u2019s:<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Diagnoses<\/li>\n\n\n\n<li>Care management activities<\/li>\n\n\n\n<li>Quality measure requirements\u00a0<\/li>\n<\/ul>\n\n\n\n<p class=\"wp-block-paragraph\">These documents should be regularly recorded in the EHR. After all, strong documentation results in improved reporting accuracy and reduces the risk of audit findings.<\/p>\n\n\n\n<h3 class=\"wp-block-heading\"><strong>Perform Internal Audits<\/strong><\/h3>\n\n\n\n<p class=\"wp-block-paragraph\">Audits help verify the submitted data and the corresponding documentation before submission for QPP. It also helps meet the CMS requirements seamlessly. Some ideal factors to review include:<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Measure performance<\/li>\n\n\n\n<li>Numerator and denominator accuracy<\/li>\n\n\n\n<li>Annual workflow compliance<\/li>\n<\/ul>\n\n\n\n<p class=\"wp-block-paragraph\">During periodic audits, practices can identify and rectify errors prior to deadlines and ensure report accuracy.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\"><strong>Wrapping It Up<\/strong><\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">The Quality Payment Program is Medicare&#8217;s value-based payment framework for eligible clinicians participating through MIPS or Advanced APMs.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">A clinician&#8217;s Medicare reimbursement may be affected based on performance across the MIPS categories. Nonetheless, clinicians who want to optimize performance and reimbursement under MIPS should understand QPP requirements.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">MediBillMD\u2019s <a href=\"https:\/\/medibillmd.com\/services\/medical-billing-services\" target=\"_blank\" rel=\"noreferrer noopener\"><strong>medical billing services<\/strong><\/a> work in tandem with QPP-aligned claim submission workflows. This way, data in your claims supports performance reporting rather than opposing it.<\/p>\n\n\n\n<p class=\"has-text-align-center wp-block-paragraph\" style=\"padding-top:0;padding-bottom:0;font-size:30px\"><strong>FREQUENTLY ASKED QUESTIONS<\/strong><\/p>\n\n\n<div class=\"wp-block-uagb-faq uagb-faq__outer-wrap uagb-block-55da6e02 uagb-faq-icon-row uagb-faq-layout-accordion uagb-faq-expand-first-true uagb-faq-inactive-other-true uagb-faq__wrap uagb-buttons-layout-wrap uagb-faq-equal-height     \" data-faqtoggle=\"true\" role=\"tablist\"><script type=\"application\/ld+json\">{\"@context\":\"https:\\\/\\\/schema.org\",\"@type\":\"FAQPage\",\"@id\":\"https:\\\/\\\/medibillmd.com\\\/blog\\\/quality-payment-program\\\/\",\"mainEntity\":[{\"@type\":\"Question\",\"name\":\"<strong>Who is eligible for QPP?<\\\/strong>\",\"acceptedAnswer\":{\"@type\":\"Answer\",\"text\":\"According to the CMS QPP <a href=\\\"https:\\\/\\\/www.ecfr.gov\\\/current\\\/title-42\\\/chapter-IV\\\/subchapter-B\\\/part-414\\\/subpart-O\\\">regulations<\\\/a>, MIPS-eligible clinicians include physician assistants, physicians (MDs and DOs), clinical nurse specialists, nurse practitioners, CRNAs, and several other Medicare Part B billing clinicians.<br><br>To be eligible for MIPS participation, clinicians must meet CMS eligibility and low-volume threshold requirements, which may change from year to year. Practices should verify the current thresholds through CMS guidance.\\u00a0\"}},{\"@type\":\"Question\",\"name\":\"<strong>Which act mandated the Quality Payment Program?\\u00a0<\\\/strong>\",\"acceptedAnswer\":{\"@type\":\"Answer\",\"text\":\"Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) mandated the QPP. It was enacted on April 16, 2015, when MACRA repealed the Sustainable Growth Rate (SGR) formula.\\u00a0<br><br>The SGR formula had repeatedly threatened reductions in physician reimbursement before its repeal. Thus, it was repealed and replaced by the QPP.\"}}]}<\/script><div class=\"wp-block-uagb-faq-child uagb-faq-child__outer-wrap uagb-faq-item uagb-block- \" role=\"tab\" tabindex=\"0\"><div class=\"uagb-faq-questions-button uagb-faq-questions\">\t\t\t<span class=\"uagb-icon uagb-faq-icon-wrap\">\n\t\t\t\t\t\t\t\t<svg xmlns=\"https:\/\/www.w3.org\/2000\/svg\" viewBox= \"0 0 448 512\"><path d=\"M432 256c0 17.69-14.33 32.01-32 32.01H256v144c0 17.69-14.33 31.99-32 31.99s-32-14.3-32-31.99v-144H48c-17.67 0-32-14.32-32-32.01s14.33-31.99 32-31.99H192v-144c0-17.69 14.33-32.01 32-32.01s32 14.32 32 32.01v144h144C417.7 224 432 238.3 432 256z\"><\/path><\/svg>\n\t\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t<span class=\"uagb-icon-active uagb-faq-icon-wrap\">\n\t\t\t\t\t\t\t\t<svg xmlns=\"https:\/\/www.w3.org\/2000\/svg\" viewBox= \"0 0 448 512\"><path d=\"M400 288h-352c-17.69 0-32-14.32-32-32.01s14.31-31.99 32-31.99h352c17.69 0 32 14.3 32 31.99S417.7 288 400 288z\"><\/path><\/svg>\n\t\t\t\t\t\t\t<\/span>\n\t\t\t<span class=\"uagb-question\"><strong>Who is eligible for QPP?<\/strong><\/span><\/div><div class=\"uagb-faq-content\"><p>According to the CMS QPP <a href=\"https:\/\/www.ecfr.gov\/current\/title-42\/chapter-IV\/subchapter-B\/part-414\/subpart-O\" rel=\"nofollow noopener\" target=\"_blank\">regulations<\/a>, MIPS-eligible clinicians include physician assistants, physicians (MDs and DOs), clinical nurse specialists, nurse practitioners, CRNAs, and several other Medicare Part B billing clinicians.<br><br>To be eligible for MIPS participation, clinicians must meet CMS eligibility and low-volume threshold requirements, which may change from year to year. Practices should verify the current thresholds through CMS guidance.\u00a0<\/p><\/div><\/div><div class=\"wp-block-uagb-faq-child uagb-faq-child__outer-wrap uagb-faq-item uagb-block- \" role=\"tab\" tabindex=\"0\"><div class=\"uagb-faq-questions-button uagb-faq-questions\">\t\t\t<span class=\"uagb-icon uagb-faq-icon-wrap\">\n\t\t\t\t\t\t\t\t<svg xmlns=\"https:\/\/www.w3.org\/2000\/svg\" viewBox= \"0 0 448 512\"><path d=\"M432 256c0 17.69-14.33 32.01-32 32.01H256v144c0 17.69-14.33 31.99-32 31.99s-32-14.3-32-31.99v-144H48c-17.67 0-32-14.32-32-32.01s14.33-31.99 32-31.99H192v-144c0-17.69 14.33-32.01 32-32.01s32 14.32 32 32.01v144h144C417.7 224 432 238.3 432 256z\"><\/path><\/svg>\n\t\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t<span class=\"uagb-icon-active uagb-faq-icon-wrap\">\n\t\t\t\t\t\t\t\t<svg xmlns=\"https:\/\/www.w3.org\/2000\/svg\" viewBox= \"0 0 448 512\"><path d=\"M400 288h-352c-17.69 0-32-14.32-32-32.01s14.31-31.99 32-31.99h352c17.69 0 32 14.3 32 31.99S417.7 288 400 288z\"><\/path><\/svg>\n\t\t\t\t\t\t\t<\/span>\n\t\t\t<span class=\"uagb-question\"><strong>Which act mandated the Quality Payment Program?\u00a0<\/strong><\/span><\/div><div class=\"uagb-faq-content\"><p>Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) mandated the QPP. It was enacted on April 16, 2015, when MACRA repealed the Sustainable Growth Rate (SGR) formula.\u00a0<br><br>The SGR formula had repeatedly threatened reductions in physician reimbursement before its repeal. Thus, it was repealed and replaced by the QPP.<\/p><\/div><\/div><\/div>\n\n\n<p class=\"wp-block-paragraph\"><\/p>\n","protected":false},"excerpt":{"rendered":"<p>Improving care quality and patient outcomes has become a central objective of the U.S. healthcare system. 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