Wound Care Articles and Insights
August 4, 2016

CMS Incentive Program Update

Melissa Bailey

Just when we thought we were on track with the CMS incentive (punitive) programs; CMS is once again changing the rules.  Now replacing MU, PQRS, and VBM will be MACRA, MIPS, and Advanced APM.

So here is a breakdown of the acronyms:


MU - Meaningful Use – Electronic Health Record Incentive Program

PQRS – Physician Quality Reporting System – Quality Reporting Program

VBM – Value Based Modifier – Value Over Volume Program


MACRA – Medicare Access Chip Reauthorization Act

MIPS – Merit-based Incentive Payment System

Advanced APM – Advanced Alternative Payment Model

MACRA, also known as the “doc fix” bill was released by CMS on April 27, 2016 as a proposed rule.  MACRA repeals the Medicare Part B Sustainable Growth Rate (SGR) and replaces it with the Quality Payment Program (QPP).  This value-based system consists to two tracks:

The Merit-based Incentive Payment System (MIPS)
Advanced Alternative Payment Models (Advanced APMs)

CMS has combined the existing Medicare Meaningful Use (MU), Physician Quality Reporting System (PQRS), and Value-Based Modifier (VBM) programs into MIPS.  The new MIPS program will become effective in the CY2017 performance year.  Payment adjustments for 2017 will be applied to the CY2019 reimbursement.

Following you will find a website published by CMS introducing the new incentive programs:

 Before diving too deeply into the detail of the new programs, please be aware we have 6 months and possibly more for CMS to make adjustments to the criteria.  And recently, CMS Acting Administrator Andy Slavitt stated he is reconsidering the start date of the Medicare payment reform programs.

In this WCA Blog, The Physician Alliance, we will continue to post information and explanations relevant to the new CMS programs.  Due to the complexity of the programs, we will be posting information in segments to assist in a more simplistic understanding of the convoluted detail of the CMS architecture.

I look forward to your feedback.

Terrie A. Dittmeyer, RN, BSN, MBA


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