Will the Medicare Physician Value-Based Payment Modifier Affect Your Anesthesia Group?

If you are an anesthesiologist practicing in a group of 100 or more eligible professionals (EPs) and submitting claims to Medicare under a single taxpayer number, you may be subject to the Value Based Payment Modifier (VBPM) in 2015.  By 2017, all physicians participating in Fee-for-Service Medicare will be affected by the VBPM.  This Alert is intended to help anesthesiologists familiarize themselves with the VBPM. The VBPM program, as provided for in the Affordable Care Act, is designed to connect the cost and quality of medical services in order to pay for “value” rather than the quantity of care.  It combines quality measures under the Physician Quality Reporting System (PQRS) with cost measures and a payment adjustment. The VBPM and PQRS are related but independent.  Readers are reminded that EPs who do not participate in PQRS in 2013 are subject to a -1.5% payment adjustment in 2015.  Non-participation in 2014 and...
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