Last week, CMS reported the outcome of the 2016 Value Modifier program, an initiative to encourage physicians to report quality-of-care information and improve patient care, and the results were rather underwhelming.
CMS looks at six factors to determine the level of quality of care, including effective clinical care, a person-centered experience, patient safety, communication and care coordination. CMS also evaluates physicians based on per capita costs for beneficiaries.
Of the 13,813 physician groups with 10 or more eligible professionals that are subject to the 2016 Value Modifier based on performance in 2014:
- less than 1% (128) of groups exceeded program benchmarks will receive an increase in Medicare payments;
- nearly 40% (5,418) of groups will receive lower payments due to failure to provide sufficient data; and
- the remaining 60% will see no change in their payments due to performance.
As we’ve reported before, physicians are leaving money on the table by not taking advantage of these government reimbursement programs designed to improve the patient experience.