2018 Value Modifier Results and Payment Adjustment Factor Released

January 2018 ~

CMS has announced the results of the final 2018 Value Modifier and the adjustment factor that will be applied to clinicians receiving an upward payment adjustment.

Currently, clinicians receive payment adjustments based on the quality and cost of care they provide their patients. The Value Modifier payment adjustment ends in 2018. The Merit-based Incentive Payment System (MIPS) under the new Quality Payment Program (QPP) is replacing the Value Modifier.

Eligible clinicians (physicians, nurse practitioners, physician assistants, clinical nurse specialists, and certified registered nurse anesthetists) who met the minimum quality reporting requirements will see positive or neutral payment adjustments. Downward payment adjustments are applied only to clinicians in practices that did not meet these minimum quality reporting requirements.

As a result of policy changes included in the 2018 MPFS, practices that reported quality data and would have received downward adjustments due to performance based on Value Modifier policies in previous years were held harmless. CMS noted that in 2018, the “overwhelming majority of clinicians received neutral payment adjustments”.

According to the agency, this year, over 20,000 clinicians will receive an increase of 6.6% to 19.9% on their Medicare physician fee schedule (MPFS) payments as a result of their high performance on quality and cost measures in 2016.

For more information, view the 2018 Value Modifier results and the payment adjustment factor on the 2016 QRUR and 2018 Value Modifier webpage.

Source(s): 2018 Value Modifier Results Fact Sheet (pdf); Value-Based Payment Modifier 2018 X-Factor Calculation Letter; 2016 QRUR and 2018 Value Modifier Webpage; Value-Based Payment Modifier Webpage; Quality Payment Program Webpage;