Understanding the QPP: Key Points and Resources

With RDNs now eligible to participate in Track One of the Quality Payment Program, the time is now to better understand the program and the financial impact it can have on RDNs. It is easy to feel overwhelmed when first introduced to Medicare's QPP. There is a great deal of information to assimilate. Fortunately, there are many QPP educational resources from the Centers for Medicare and Medicaid Services along with information and support provided by the Academy. Below you'll find key information about the QPP and further educational resources about it.

QPP Key Points

  • The QPP was created as Medicare needed to shift away from Fee for Service payments that were projected to bankrupt the system. There was strong bipartisan support for the legislation that created the QPP, so it is here to stay.
  • The QPP is a payment system with performance based financial incentives. From 2017-2019, there were minimal annual increases (0.5 percent) to the Part B Physician Fee Schedule and no increases beginning in 2020 through 2025.
  • The QPP allows RDNs to demonstrate the importance of their profession as well as the value RDNs bring to clients, the health care team, and organizations.
  • Annual updates to the program by CMS are based on provider feedback and help shape the program’s future success.
  • The QPP consists of two tracks and eligible Medicare providers can participate in the QPP in a variety of ways.
  • Track one of the QPP is for eligible clinicians who participate in either the Traditional Merit-based Incentive Payment System (MIPS) or as part of a MIPS Alternative Payment Model (MIPS APM).
  • Track two of the QPP is for eligible clinicians who participate in Advanced APMs.
  • RDNs are eligible clinicians and can participate in MIPS if they exceed all three of the low-volume threshold criteria; they also can opt into MIPS if they meet or exceed one or two but not all three of the low-volume threshold criteria. With either option RDNs will be subject to payment adjustments.
  • RDNs are exempt from MIPS if they do not exceed all three of the low-volume threshold criteria, however they can prepare for future participation by choosing to voluntarily report under MIPS.
  • RDNs who voluntarily report will receive an annual feedback report to learn how to maximize future financial incentives under MIPS but will not be subject to payment adjustments.
  • In the 2020 Medicare Physician Fee Schedule, CMS introduced a framework designed to promote more meaningful reporting within the QPP program, the MIPS Value Pathways or MVPs. The goal will be for eligible clinicians participating in Traditional MIPS reporting to transition to MVP reporting. CMS will continue to develop MVPs during 2021.

Additional Resources for Learning about the QPP

It takes time and repeated exposure to gain a working knowledge of the two tracks of the QPP. RDNs can learn more about the QPP by utilizing resources from the Academy and CMS: