MACRA: Medicare Access and CHIP Reauthorization Act of 2015
2015 law that repealed the sustainable growth rate formula for determining Medicare payments and created two new performance-based payment tracks: the Merit-Based Incentive Payment System and alternative payment models. Read More
SGR: Sustainable Growth Rate
Former Medicare formula to calculate physician fee-for-service payment rates. Repealed by MACRA.
MIPS: Merit-Based Incentive Payment System
One of two payment tracks under MACRA. MIPS consolidates the Centers for Medicare & Medicaid Services’ Physician Quality Reporting System, Value-Based Payment Modifier Program, and Electronic Health Records Incentive Programs into one single program starting in 2019.
APMs: Alternative Payment Models
One of two payment tracks under MACRA. Examples include accountable care organizations, patient-centered medical homes, bundled payment models, and other initiatives.
PQRS: Physician Quality Reporting System
Medicare program asking physicians to document and report on clinical quality measures. Scores feed into the Value-Based Payment Modifier Program. Read More
VM: Value-Based Payment Modifier
Medicare calculation to adjust physician fee-for-service payments either up or down based on how they perform on quality and cost factors. Read More
MU: Meaningful Use
Refers to meaningful use of electronic health records, which is the objective of the Centers for Medicare & Medicaid Services’ Electronic Health Records Incentive Programs. Read More
CPIA: Clinical Practice Improvement Activity
A new Medicare performance category that may help physicians gain some credit under MIPS. CPIA subcategories are expanded access, population management, care coordination, patient engagement, patient safety and practice assessment, and transition to or participation in an alternative payment model. New rules will define the criteria.
QCDR: Qualified Clinical Data Registry
An entity approved by the Centers for Medicare & Medicaid Services that collects medical and/or clinical data for the purpose of patient and disease tracking to foster improvement in the quality of care provided to patients. Read More
CAHPS: Consumer Assessment of Healthcare Providers and Systems
Patient satisfaction and experience surveys. Read More
QRUR: Quality and Resource Use Report
Medicare feedback reports on physicians’ quality and resource use (cost) scores and how their performance compares with that of their peers. Read More
ACO: Accountable care organization
AF: Adjustment factor
APMs: Alternative payment models
CAHPS: Consumer Assessment of Healthcare Providers and Systems
CEHRT: Certified electronic health record technology
CHIP: Children’s Health Insurance Program
CMMI: Center for Medicare & Medicaid Innovation
CMS: Centers for Medicare & Medicaid Services
CPIA: Clinical practice improvement activity
CQM: Clinical quality measures
EHR: Electronic health record
EIDM: Enterprise Identity Management System
EP: Eligible professional
FFS: Fee-for-service
MACRA: Medicare Access and CHIP Reauthorization Act of 2015
MSPB: Medicare spending per beneficiary
MIPS: Merit-Based Incentive Payment System
MPFS: Medicare Physician Fee Schedule
MSSP: Medicare Shared Savings Program
MU: Meaningful use
NPI: National Provider Identifier
PCMH: Patient-centered medical home
PECOS: Provider Enrollment, Chain, and Ownership System
PFPM: Physician-focused payment model
PQRS: Physician Quality Reporting System
QCDRs: Qualified clinical data registries
QP: Qualifying alternative payment model participant
QRUR: Quality and Resource Use Report
SGR: Sustainable Growth Rate
TIN: Taxpayer Identification Number
VM: Value-Based Payment Modifier Program
Source: Centers for Medicare & Medicaid Services