2012-07-23

Officials at the Centers for Medicare and Medicaid Services (CMS) will hold a national call on Wednesday, August 1, from 2:30 - 4:00 p.m. ET. The discussion will focus on the proposed implementation of a provision in the Affordable Care Act (ACA) that will apply a value-based modifier to physicians' Medicare payment rates. As stipulated in the ACA, the program is being phased in over three years, beginning in 2015. It is budget neutral and therefore will result in payment increases for some physicians and reductions for others. CMS is proposing to base the 2015 payment adjustments on physicians' quality and resource use in 2013 and to apply the modifier only to physicians who practice in groups of 25 or more physicians and other health professionals. By 2017, the modifier will be applied to all physicians. Additional details on CMS's proposed implementation of the value based modifier can be found on pages 559-622 of the proposed 2013 physician fee schedule.

The presentation will describe the options these groups have on how the value modifier would be calculated based on whether they participate in the Physician Quality Reporting System (PQRS). For groups of 25 or more that do not participate in the PQRS, CMS is proposing to set their Value Modifier at a 1.0 percent payment reduction. For groups that wish to have their payment adjusted according to their performance on the value modifier, the rule proposes a system whereby groups with higher quality and lower costs would be paid more, and groups with lower quality and higher costs would be paid less.

A question and answer session will follow the presentation. Registration is required for this call. The presentation for this call will be posted prior to the call on the FFS National Provider Calls web page. In addition, a link to the slide presentation will be emailed to all registrants on the day of the call.

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