Few Winners in the Final Year of Value Modifier Program

January 26th, 2018

The results of the final Medicare Value Modifier are in, and a small percentage of physicians saw increased reimbursement, according to a report from the Centers for Medicare & Medicaid Services (CMS).

The Value Modifier program adjusts payments to eligible clinicians based on meeting quality and cost measure performance and reporting thresholds. Physicians and certain other healthcare providers receive neutral or positive payments based on meeting or exceeding minimum performance criteria. Those clinical practices that did not meet the minimum requirements received decreased payment adjustments. This year, 20,000 physicians, or 1.8%, will receive positive payment adjustments on their Medicare physician fee schedules, ranging from 6.6% to 19.9% more. The “overwhelming majority” of clinicians — more than 746,000, or 64.8% — will receive neutral adjustments, according to the CMS report.

This year marks the end of the Value Modifier program. It will be replaced by the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) and its two payment tracks: Merit-based Incentive Payment System (MIPS) and Advanced Alternative Payment Models (APMs).

For more information on MIPS and how to maximize reimbursement under the new program, see the Relias on-demand webinar, Maximize Your Money Under New CMS & TJC Regulations.