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A variety of programs have been developed to address value-based care payment, including the Medicare Quality Payment Program, or QPP.
Medicare and commercial payers continue the move toward value-based payment, shifting from payment solely based on the volume of care, such as traditional fee-for-service, to payment more closely related to outcomes of care. Value-based payment models use measures of quality and cost to determine payment for providers. Ensuring high quality of care while controlling cost is key to success in these models. Physical therapists must use standardized quality measures to articulate the value they bring to the health care system, as the shift toward payment that is dependent upon quality-measure performance continues.
A variety of programs have been developed to address value-based care payment, including the Medicare Quality Payment Program, or QPP.
Starting in 2019, the Centers for Medicare and Medicaid Services required certain PTs and physical therapy practices to participate in QPP through the Merit-based Incentive Payment System, or MIPS, or Advanced Alternative Payment Models, or APMs.
Physical Therapists: The Value We Bring
What is APTA doing? Recognizing the health care payment shift toward value, APTA in 2013 approved funding for the Physical Therapy Outcomes Registry. The Registry uses data from the profession, for the profession, to help you elevate your patient care, visualize your value, and define your future.
The Registry provides information that physical therapists can use to improve the quality and safety of the care they provide to their patients and clients. For example, the Registry can help PTs assess their compliance with evidence-based clinical practice guidelines. The Registry can provide information about outcomes of care, and PTs will use it increasingly within value-based payment models to ensure that payment is adjusted based on the quality of care provided.
Quality Measure Resources
2018 quality measures for MIPS and post-acute care reporting.
Provides details on NQF-endorsed measures.
CMS risk adjustment resource.
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CMS has proposed changes to the 2019 physician fee schedule that would require eligible PTs to participate in Medicare's Quality Payment Program next year. To prepare, PTs must understand what's behind these efforts, what they need to do, and what may lie ahead.
Mar 23, 2018 / Review
As health care moves toward value-based approaches, it's going to become increasingly important for PTs and OSs to pursue more "collaboration and consistency" when it comes to outcome measures used in total knee and hip arthroplasty cases, say authors of a new study.
Jan 26, 2018 / Podcast
This is episode 5 of APTA’s comprehensive podcast series that explains the move toward value-based care and how physical therapists can participate in the Quality Payment Program. This episode asks “How Are PTs Measured?”