Payment & CMS Policy


List of PCP Quality Measures for 2018


For 2018, reporting through the Quality Payment Program (QPP) starts with the selection of measures for the year. CMS has a set of 30 Primary Care Measures and you will select six of the 30 for the reporting year 2018. Select measures that are pertinent to the Medicare base of your practice. Also, consider measures that you can improve on during the year.

Need help? Contact MIPSPRO to set up a free live session with a MIPS expert, and let them know you are an ACOFP member.

MIPS Reporting for 2018
The Quality Payment Reporting period for 2018 starts January 1, 2019 and ends March 15, 2019. View the steps to reporting your 2018 quality improvement data. This is the first year that Cost will be part of the MIPS Composite Score and will affect your payment adjustment. Learn about the four areas of reporting for MIPS – Quality, Cost, Practice Improvement Activities, and Interoperability (previously Advancing Care Information).

This webinar is brought to you by Healthmonix and MIPSPRO. Sign up with MIPSPRO to monitor your measures quarterly and report at the end of the year. Use code ACOFP for a discount. Even if you don’t not have an EMR, MIPSPRO can assist you to report for 2018!

Medicare Diabetes Prevention Program - 2019 Updates
Diabetes impacts more than 25 percent of Americans age 65 or older. Diabetes is expected to increase two-fold for all adults in the US aged 18-79 if current trends continue. The program was successful in 2018 and CMS has provided updates for the Diabetes Prevention Program (DPP) starting January 1, 2019. The prevention program targets those with prediabetes using a health behavior change methodology. Physicians are awarded payment bonuses, in addition to payment for HCPCS G-codes, based on patient success of weight loss combined with number of educational meetings attended. View the CMS Fact Sheet for more information.

ACOFP Comment Letters to CMS and  Government Health Agencies
Through 2018, ACOFP and Washington based Alston & Bird, have developed and sent comment letters to CMS and other health focused government agencies to request change that will benefit patients, physicians and the healthcare system. There were 16 comment letters in 2018 that aligned with ACOFP’s priorities in healthcare reform. 

2019 Chronic Care Management (CCM) Toolkit & Teaching Materials from CMS: 
Chronic care management (CCM) is a critical component of primary care that contributes to better outcomes and higher satisfaction for patients. On January 1, 2017, CMS established separate payment under billing codes for the additional time and resources physicians spend to provide appointment and between-appointment help that many Medicare and dual-eligible (Medicare and Medicaid) patients need to stay on track with their treatments and plan for better health. CCM payments can be made for services furnished to patients with two or more chronic conditions who are at significant risk of death, acute exacerbation/decompensation or functional decline. CMS data shows that two thirds of people on Medicare have two or more chronic conditions, which means many of your patients may benefit from a CCM program, including the help provided between visits. This toolkit includes information for health care professionals, including tips for getting started, fact sheets on the requirements for implementing a CCM program and educational materials to share with patients.