Value-based Payment Modifier Initiative Winds Down

The year 2018 is the final year for the initiative of the Value-Based Payment Modifier by the Centers for Medicare and Medicaid Services. It was created to provide for differential payment to physicians based on the quality of care furnished compared to the cost of care during a performance period in an attempt to reduce unnecessary items and services. How has it impacted physicians’ reimbursement thus far? Not good.

As noted by CMS, in 2018

3,478 total practices (1.7 percent) representing 20,48l total clinicians will receive an upward payment adjustment,
74,024 practices (35.7 percent) representing 746,556 clinicians can plan on a neutral payment adjustment based on their performance,
8,007 practices (3.9 percent) representing 87,841 clinicians were held harmless and will see a neutral payment adjustment, and
121,642 practices (58.7 percent) representing 296,475 clinicians will get a downward adjustment in their Medicare payment because they failed to report quality measures.

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