DecisionHealth, DecisionHealth - 2012 Issue 7 (July)

ACA’s payment modifier would reward or penalize large practices in 2015

Based on their performance in 2013, practices with 25 or more providers would be subject to a 1% payment penalty or an unspecified bonus in 2015 from CMS’ value-based payment modifier, an Affordable Care Act reform that would apply to all practices in 2017.

The payment modifier, aligned closely to the Physician Quality Reporting System (PQRS), has been called a potential “game-changer” by the Medical Group Management Association because it will pay practices based on the quality of care compared with cost.

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