What Is QPP? Understanding the Quality Payment Program
                     What Is QPP? 
Understanding the 
Quality Payment 
Program
• The Quality Payment Program (QPP) is a vital 
initiative aimed at transforming how Medicare 
providers are reimbursed for services rendered 
to Medicare beneficiaries. Established under the 
Medicare Access and CHIP Reauthorization Act 
(MACRA) in 2015, the QPP replaced the outdated 
Sustainable Growth Rate (SGR) formula.
• The program incentivizes high-quality care rather 
than simply compensating for the quantity of 
services provided. This shift reflects a growing 
trend toward value-based care, ensuring that 
Medicare beneficiaries receive efficient, patient-
centered treatment.
• For small medical practice owners, the QPP 
can be an opportunity to improve care quality 
and enhance financial sustainability. However, 
navigating the complexities of the program 
requires a solid understanding of its 
components and requirements.
What Is the Quality Payment 
Program?
• The QPP is designed for Medicare providers 
and divides participants into two tracks:
• Merit-based Incentive Payment System 
(MIPS)
    This track measures clinicians based on four 
categories:
– Quality
– Cost
– Improvement Activities
– Promoting Interoperability
• MIPS-eligible clinicians, such as physicians, nurse 
practitioners, and physician assistants, are scored 
annually. Their scores influence future Medicare 
payments—positive scores can lead to bonuses, 
while negative scores may result in penalties.
Advanced Alternative 
Payment Models (APMs)
• This track involves participating in risk-bearing 
payment models that focus on specific 
populations or conditions. Practices participating 
in advanced alternative payment models take on 
more financial risk but can earn greater rewards 
for achieving quality and cost targets.
• To read our full blog, click here: https
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ality-payment-program
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