Value Modifier
U.S. Department of Health & Human Services
@usgov.hhs_gov_value_modifier_19108
U.S. Department of Health & Human Services
@usgov.hhs_gov_value_modifier_19108
The Medicare Value-Based Payment Modifier (Value Modifier) data contains the performance results of de-identified practices that were subject to the Value Modifier, such as the practices' quality and cost tiers along with any applicable Value Modifier payment adjustment. The Value Modifier provided for differential payment under the Medicare Physician Fee Schedule based on the quality of care furnished to Medicare beneficiaries compared to the cost of care during a performance period. Calendar Year 2015 was the first payment adjustment period under the Value Modifier based on performance in 2013. Calendar Year 2018 was the final payment adjustment period under the Value Modifier based on performance in 2016.
The Merit-based Incentive Payment System (MIPS) under the Quality Payment Program has replaced the Value Modifier program. The Centers for Medicare & Medicaid Services (CMS) encourages everyone to learn more about the Quality Payment Program.
Organization: U.S. Department of Health & Human Services
Last updated: 2022-01-25T02:03:41.422410
Tags: medicare, original-medicare, payment-models, value-based-care
CREATE TABLE value_modifier_2013_12_31 (
"practice_id" BIGINT,
"state" VARCHAR,
"num_eps_vm" VARCHAR,
"gpro" BIGINT,
"elig_up_adjust" VARCHAR,
"category" VARCHAR,
"vm_payment_adj" VARCHAR,
"updated_vm" VARCHAR,
"cost_comp_tier_text" VARCHAR,
"qual_comp_tier_text" VARCHAR,
"zb_cost_cmpscr_pool_rnd" VARCHAR,
"zb_qual_cmpscr_pool_rnd" VARCHAR
);CREATE TABLE value_modifier_2014_12_31 (
"practice_id" BIGINT,
"state" VARCHAR,
"num_eps_vm" VARCHAR,
"gpro" BIGINT,
"elig_up_adjust" VARCHAR,
"category" VARCHAR,
"vm_payment_adj" VARCHAR,
"updated_vm" VARCHAR,
"cost_comp_tier_text" VARCHAR,
"qual_comp_tier_text" VARCHAR,
"zb_cost_cmpscr_pool_rnd" VARCHAR,
"zb_qual_cmpscr_pool_rnd" VARCHAR
);CREATE TABLE value_modifier_2015_12_31 (
"practice_id" BIGINT,
"state" VARCHAR,
"num_eps_vm" VARCHAR,
"mssp" BIGINT,
"gpro" BIGINT,
"elig_up_adjust" VARCHAR,
"category" VARCHAR,
"vm_payment_adj" VARCHAR,
"updated_vm" VARCHAR,
"cost_comp_tier_text" VARCHAR,
"qual_comp_tier_text" VARCHAR,
"zb_cost_cmpscr_pool_rnd" VARCHAR,
"zb_qual_cmpscr_pool_rnd" VARCHAR
);Anyone who has the link will be able to view this.