CMS offers API to help providers navigate quality pay program

Technology makes it easier to retrieve information, keep track of program measures.


A new tool from the Centers for Medicare and Medicaid Services is designed to aid the sharing of electronic data under the Medicare Quality Payment Program that was created under the MACRA Act.

The tool is an application programming interface to retrieve and maintain Quality Payment Program measures and available here.



Clinicians are part of the Quality Payment Program in 2017 if they are in an Advanced Alternative Payment Model program with Medicare, or if they bill Medicare more than $30,000 a year and provide care for more than 100 Medicare patients annually, according to CMS. Clinicians participating in the MIPS program must be a physician, physician assistant, nurse practitioner, clinical nurse specialist or certified nurse anesthetist.

Also See: MACRA rule won’t achieve payment reform overnight

The new CMS tool includes links to the Quality Payment Program final rule along with a summary; the MACRA legislation; fact sheets for the payment program and for small practices; a list of Alternative Payment Model criteria; and a walk-through on how to design an Alternative Payment Model toolkit.

Additional tools include an implementation guide for measures specifications, resources for finding qualified clinical data registries, a video library and web seminars.

“An important part of the Quality Payment Program is to make it easier and less expensive to participate, so clinicians may focus on seeing patients,” Andy Slavitt, acting administrator at CMS, said in a statement.

Organizations that pushed for the tools and support the new services include the American Academy of Ophthalmology, the Network for Regional Healthcare Improvement, American College of Radiology, American College of Physicians, National Rural Accountable Care Consortium, Great Lakes Practice Transformation Network, Pacific Business Group on Health, National Partnership for Women & Families, and the Mountain Pacific Quality Health Foundation, among others.

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