About this Dataset

Value Modifier

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.
Organization: U.S. Department of Health & Human Services
Last updated: 2025-10-07T07:27:02.915395
Tags: medicare, original-medicare, payment-models, value-based-care

Tables

Value Modifier : 2013-12-31

@usgov.hhs_gov_value_modifier_65bf8.value_modifier_2013_12_31

23.37 kB
1,010 rows
12 columns

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
);

Value Modifier : 2014-12-31

@usgov.hhs_gov_value_modifier_65bf8.value_modifier_2014_12_31

185.3 kB
13,813 rows
12 columns

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
);

Value Modifier : 2015-12-31

@usgov.hhs_gov_value_modifier_65bf8.value_modifier_2015_12_31

2.54 MB
208,832 rows
13 columns

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
);

Value Modifier : 2016-12-01

@usgov.hhs_gov_value_modifier_65bf8.value_modifier_2016_12_01

2.52 MB
207,151 rows
13 columns

CREATE TABLE value_modifier_2016_12_01 (
  "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
);