Understanding Medicare Value-based Payment Models

October 27, 2014
Keith L. Martin

2015 is a crucial year to prove cost and quality as a Medicare provider. Here's what you need to know to avoid financial penalties down the line.

When it comes to proving cost and quality as a Medicare provider, "What you do in 2015 as a physician practice will have ramifications for a number of years going forward," according to Anders M. Gilberg.

In this video, Gilberg, senior vice president for the Medical Group Management Association's Government Affairs Office, discusses CMS' Physician Value-based Payment Modifier. In 2015, Medicare will begin applying the modifier under the physician fee schedule to various providers to show value of care.

"Cost and quality … make up the value equation, in the mind of the payer, in terms of Medicare," said Gilberg.

In addition to explaining how the modifier works, Gilberg also highlights other quality measures facing providers under the Physician Quality Reporting System and via the EHR Incentive Programs, better known as meaningful use.

A session by Gilberg's colleague, Allison Brennan, titled "Emerging Medicare Payment Models will explore this topic more in-depth at the MGMA14 Conference in Las Vegas. The session is scheduled for Tuesday, Oct. 28 from 1:30 p.m -2:30 p.m.