Health industry is evolving daily. The conventional old reimbursement methods have been upgraded to improve quality and maintain healthcare. CMS collects data from authentic sources and makes the physician ratings available on Physician Compare Portal. In this way a healthcare system progresses and maintains a database of value-based clinicians with ratings.

NCQA (National Committee of Quality Assurance) and CMS are two regulatory authorities that assess the performance of physicians and on the basis of this performance they are rewarded or penalized thus the quality of service is maintained. Physician’s performance directly affects the status of Medicare reimbursement.

P3 being a MIPS consulting service works on rewards and bonuses for their clients.

Quality based healthcare initiatives and bodies include: PCMH, PCSP, GRIP, PQRS, MIPS MACRA, HEDIS, Meaningful Use (MU)/ Promoting Interoperability (PI), Value-based Modifier (VBM) and Pay-For-Performance models. These bodies perform at assistive and sometimes at regulatory level to facilitate healthcare providers to pace up the patients wellness and decrease the healthcare expenses.

Medicare removes the costly volume-based system and replaces it with a value-based fair system. Thus, a quality healthcare system is inevitable today and in future as well and it requires performance monitoring through MACRA & MIPS and APMs.