Understanding QRURs: Have You Reviewed Yours?

2016 QRUR and 2018 Value Modifier
Note: The Value Modifier payment adjustment ends in 2018. The Merit-based incentive Payment System (MIPS) under the new Quality Payment Program is replacing the Value Modifier. We encourage everyone to learn more about the Quality Payment Program by visiting qpp.cms.gov.

2016 Annual QRURs
On September 18, 2017, CMS made available the 2016 Annual Quality and Resource Use Reports (QRURs) to every group practice and solo practitioner nationwide. The 2016 Annual QRURs show how physician, physician assistants (PAs), nurse practitioners (NPs), clinical nurse specialists (CNSs), and certified registered nurse anesthetists (CRNAs) in groups and solo practitioners performed in 2016 on the quality and cost measures used to calculate the 2018 Value Modifier and payment adjustment. Groups and solo practitioners are identified in the QRURs by their Medicare-enrolled Taxpayer Identification Number (TIN). The 2018 Value Modifier payment adjustments shown in the 2016 Annual QRURs are based on policies finalized in the 2018 Medicare Physician Fee Schedule Final Rule (82 FR 53227-53232).

The 2016 Annual QRURs show how groups and solo practitioners performed on quality and cost measures relative to national benchmarks and indicate if physicians, PAs, NPs, CNSs, and CRNAs will receive an upward, neutral or downward Value Modifier adjustment to their payments for items and services rendered under the Medicare Physician Fee Schedule in 2018. The QRURs also contain important information about care delivered to Medicare beneficiaries that can be used to better understand quality and cost performance and that can be used to improve quality and better coordinate care, including information about the hospital and other providers that see your patients.


The 2015 Mid-Year (July 1, 2014 and June 30, 2015) and Annual (January 1 to December 31, 2015) Quality and Resource Use Reports (QRURs) are now available for group practices and solo practitioners across the country, including providers who participated in the Accountable Care Organization (ACO) Shared Savings Program.  

The reports show practitioners how they performed and how their quality measures are used to calculate the Value-Based Modifier (VBM) payment adjustment.  

These reports contain exhibits on both quality and cost measures. Quality measures are measures reported via Physician Quality Reporting System (PQRS) and the Consumer Assessment of Healthcare Providers and Systems (CAHPS). Cost measures are measures reported via administrative claims. The information on your 2015 QRUR report and performance scores were recently released on the CMS Physician Compare website.  Learn more by watching the most recent AAAAI QRURs & Physician Compare webinar.

To access your QRURs, log into the CMS Enterprise Portal or visit the CMS website and click on How to Obtain a QRUR or How to Understand Your 2015 Annual QRUR.

For Physician Compare questions, suggestions, or other feedback, contact the Physician Compare Support Team at PhysicianCompare@Westat.com.

For questions about the 2016 Annual QRUR, 2018 Value Modifier, and how to request an informal review of the 2018 Value Modifier, contact the Physician Value Help Desk.
• Monday – Friday: 8:00 am – 8:00 pm EST
• Phone: 1-888-734-6433 (select option 3)
• Email: pvhelpdesk@cms.hhs.gov

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