Colorado Medical Society

Quality Payment Program proposed rule highlights

Monday, June 26, 2017

Last fall the Centers for Medicare and Medicaid Services issued the final Quality Payment Program (QPP) rule. Since that time, the AMA, with input from the federation, has continued to actively engage various parts of the administration to improve the program. These efforts paid off. Many of the policies in the proposed rule for the 2018 performance year are based on the AMA recommendations. In essence, the agency is providing another transition year. The federal CMS is also proposing a number of policies to help small practices. In sum, the agency estimates that under this proposed rule more than 94 percent of eligible clinicians would earn either a positive or neutral payment adjustment.

Because this is a proposed rule, AMA staff will work to preserve favorable provisions in the proposed rule while continuing to press for additional changes in the final rule. The proposed rule is over 1,000 pages long and AMA staff will be immersing themselves in the details in the coming weeks.

Here are some of the highlights from the proposed rule.

Additional accommodations for small practices:

Advancing care information

The AMA will continue to seek more flexible ACI measures.


The AMA will continue to urge the agency to retain topped out measures, but if the agency insists on periodically removing them the AMA recommends they implement a more systematic and transparent process.

Cost category

The AMA had urged the federal CMS to keep the score at zero for several more years and will continue to urge the agency and Congress to limit the weight of this category.

Improvement activities

The AMA will continue to work with the agency to increase the number of IAs available to physicians and strive to align the IA and ACI categories.

Alternative payment models

In addition, the federal CMS has requested comments on methods for allowing physicians’ participation in Medicare Advantage APMs to count toward the required thresholds for Advanced APM participation, as the AMA has recommended.

For the federal CMS fact sheet on the rule, click here.