News: CMS announces results from implementation of value-based payment modifier and adjustment factor

Physicians in 128 groups exceeded benchmarks in quality and cost efficiency and will receive an increase in their payments under the Medicare Physician Fee Schedule, according to an announcement from CMS, detailing the results from the implementation of the 2016 Value-based Payment Modifier and the adjustment factor that will be applied to physician groups that are subject to upward payment adjustments in 2016. 

Alternatively, physicians in 59 groups will see a decrease in their Medicare payments in 2016 based on their performance, and physicians in 5,418 groups that failed to meet minimum reporting requirements will see a decrease in their Medicare payments in 2016.

There are 13,813 physician practices with 10 or more eligible professionals that are subject to the 2016 Value Modifier based on performance in 2014.

The Value Modifier adjustment factor is determined after the close of the performance period and is based on the estimated aggregate amount of downward payment adjustments. CDI will play a critical role in maintaining and improving current quality scores by ensuring documentation is complete and accurate.

Click here for more information from CMS.