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Medicare鈥檚 Quality Payment Program (QPP)
What's New
CMS Innovation Center announced changes to its model portfolio to align with its statutory mandate and strategic goals.
- Models Identified to End Early by December 31, 2025. (Original Performance Period)
- Maryland Total Cost of Care (2019 - 2026)
- Primary Care First (2021 - 2026)
- ESRD Treatment Choices (2021 - 2027; will propose termination through rulemaking)
- Making Care Primary (2024 - 2034)
- The CMS Innovation Center is considering options to reduce the size of Integrated Care for Kids (2020 鈥 2026).
- The CMS Innovation Center will no longer pursue two previously announced but not yet implemented models given the flexibility provided by President Trump鈥檚 recission of Executive Order 14087 on January 20, 2025.
- Medicare $2 Drug List
- Accelerating Clinical Evidence
- Read more on the
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MIPS
Merit-Based Incentive Payment System
The Merit-Based Incentive Payment System (MIPS) adjusts payments based on a clinician's performance across 4 categories: Quality (30%), Promoting Interoperability (25%), Improvement Activities (15%), and Cost (30%). 听Learn more
APMs
Alternative Payment Models
APMs structure payment to incentivize quality and value. Clinicians who participate in certain 鈥淎dvanced APMs鈥 that satisfy advanced risk, quality, and technology requirements may be excluded from MIPS and eligible for a 5% Medicare bonus. Learn more
Value-Based Payment Reform Efforts
The CMS Innovation Center (CMMI) has set goals to have all Medicare beneficiaries and the vast majority of Medicaid beneficiaries in an accountable relationship by 2030. Read more .
The HCPLAN tracks nationwide progress in adopting APMs and accountable care to create a more efficient health care system. Eight years ago, HCPLAN initiated its first national Measurement Effort to evaluate APM adoption across commercial, Medicare Advantage, and Medicaid sectors. Since then, it has continuously monitored and reported on progress and changes.
See:
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Resources
ACP Advocacy
- ACP Summary of 2025 Physician Fee Schedule, Medicare Shared Savings Program, and Quality Payment Program Proposed Rule
- ACP Comments of 2025 Physician Fee Schedule, Medicare Shared Savings Program, and Quality Payment Program Proposed Rule
- ACP Comments on 2025 Physician Fee Schedule, Medicare Shared Savings Program, and Quality Payment Program Final Rule
For more information or questions or concerns regarding specific QPP/MACRA-related issues, email policy-regs@acponline.org.