Reporting requirements for physical therapists (PTs) in private practice are changing under the Quality Payment Program—specifically through the Merit-based Incentive Payment System (MIPS) and alternative payment models (APMs). To thoroughly explain each program, MIPS is covered here, and APMs will be examined in the May issue of PT in Motion.
Since 2007, PTs in private practice have been participating in the Physician Quality Reporting System (PQRS), which was designed to better ensure high-quality health care services for Medicare beneficiaries. On January 1, PQRS became a "legacy" program and was rolled into the Merit-based Incentive Payment System (MIPS)—which, in turn, is part of the new Quality Payment Program (QPP) created by the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA). (CHIP stands for Children's Health Insurance Program.)
The QPP's goals, according to the Centers for Medicare and Medicaid Services (CMS), are to: "(1) support care improvement by focusing on better outcomes for patients, decreased provider burden, and preservation of independent clinical practice; (2) promote adoption of alternative payment models that align incentives across health care stakeholders; and (3) advance existing efforts of Delivery System Reform, including ensuring a smooth transition to a new system that promotes high-quality, efficient care through unification of CMS legacy programs (including PQRS)."