Primary Care Clinician Participation in the CMS Quality Payment

This brief examines primary care clinician participation in the Quality Payment Program (QPP), parsed by clinician type, clinician specialty, clinician practice location, and Advanced Alternative Payment Model (A-APM) or Merit-Based Incentive Payment System (MIPS) program participation. We found that approximately 10% of primary care clinicians participate in A-APMs and less than 30% of primary care clinicians participate in MIPS. Thus, nearly 60% of primary care clinicians are exempt from MIPS and do not participate in an A-APM. Metropolitan primary care clinicians are more likely to participate in A-APMs than nonmetropolitan primary care clinicians. To realize QPP goals of improved health outcomes and smarter spending, the Centers for Medicare & Medicaid Services (CMS) could consider QPP updates that specifically advance primary care clinician participation. Furthermore, CMS could develop A-APMs and programs that specifically include nonmetropolitan primary care clinicians.