The Centers for Medicare & Medicaid Services (CMS) proposed major policy changes to ensure clinicians spend more time providing high-value care for patients instead of filing cumbersome paperwork.
As part of CMS’ annual changes to the Medicare Physician Fee Schedule and Quality Payment Program, the agency’s proposals aim to reduce burden, recognize clinicians for the time they spend with patients, remove unnecessary measures, and make it easier for them to transition from volume-based to value-based care.
This proposed rule builds on the Trump Administration’s efforts to establish a patient-driven healthcare system that focuses on better health outcomes and is projected to save 2.3 million hours per year in burden reduction.

Key proposals

Key proposals for the 2020 performance year of the Quality Payment Program include:

  • Increasing the performance threshold from 30 points to 45 points
  • Revising category weights for quality (decreases from 45% to 40%) and cost (increases from 15% to 20%)
  • Increasing the data completeness threshold for the quality data that clinicians submit
  • Increasing the threshold for clinicians who complete or participate in the improvement activity for group reporting
  • Updating requirements for Qualified Clinical Data Registry (QCDR) measures and the services that third-party intermediaries must provide (beginning with the 2021 performance period)
  • Revising the specifications for the Total Per Capita Cost (TPCC) and Medicare Spending Per Beneficiary Clinician (MSPB Clinician) measures


Find out more

Read the press release announcing this proposal here.

See a fact sheet on the CY 2020 Physician Fee Schedule proposed rule here.

Get to know the CY 2020 Physician Fee Schedule and Quality Payment Program proposed rule here.

You don’t have to navigate this payment change alone. Visit our website and subscribe to our YouTube channel for more PDPM updates and resources.

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