Health Policy
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Healthcare is a more dynamic market and now more than ever urgent care professionals need to stay informed on key issues affecting their patients' care. Be sure to stay up-to-date on health policy issues and the potential impact they may have on the urgent care industry by checking out the resources below.

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Value Based Reimbursement State by State: A 50-State Review of Value-Based Payment Innovation (June 21, 2018): The Payer Relations Committee discussed this item on a recent call and how it connects them with the Health and Public Policy Committee. This can serve as a valuable resource to UCA members as this report seeks to shed light on this other work through an examination of state-level value-based payment initiatives underway across America. Overall, five states stand out for the breadth of their initiatives, their embrace of payment models that involve shared risk, and their willingness to test innovative strategies. Please read the full report here.

UCAOA Offers Support on Pending MO Bone Marrow Bill (April 6, 2018)In a letter to members of the Missouri General Assembly, UCAOA offered support of the pending legislation that would encourage, but not require, primary care providers and urgent care physicians to inquire of new patients whether they are registered with the bone marrow registry. If a patient is not registered, the health care provider would provide information about the bone marrow registry. In its letter of support, UCAOA emphasized the importance of giving health care providers flexibility to voluntarily support initiatives to increase the number of potential bone marrow donors. The legislation has passed the Missouri House is now pending in the Senate. Send your thoughts, ideas and experiences to Nirja Shah at

Senators Solicit Views on Price Transparency; UCAOA Responds (April 3, 2018): Sens. Bill Cassidy, M.D. (R-LA), Michael Bennet (D-CO), Chuck Grassley (R-IA), Tom Carper (D-DE), Todd Young (R-IN), and Claire McCaskill (D-MO) are seeking feedback from the health care and patient communities as they develop legislation to improve price transparency in the health care market. In response to the solicitation, UCAOA submitted comments that the lack of price and information transparency is a contributor to hospital emergency department overuse. The Association also highlighted that many consumers dont know the difference on when to seek care at a free-standing emergency department versus an urgent care center and the associated costs a distinction that may not become apparently until after a patient received a bill for care provided in a free-standing emergency department that includes a facility charge. The Health & Public Policy Committee is interested in better understanding state-level price transparency requirements from an urgent care center perspective.  Send your thoughts, ideas and experiences to Nirja Shah at

UCA and CUCM Recommend Urgent Care Medicine Measure Set (February 15, 2018): On February 9, the Urgent Care Association (UCA) in collaboration with the College of Urgent Care Medicine (CUCM) submitted a letter to the Centers for Medicare and Medicaid Services (CMS) in response to a call for recommendations for specialty quality measure sets for the 2019 performance year of the Merit-Based Incentive Payment System (MIPS). If CMS agrees with UCA and CUCM and develops an urgent care medicine specialty set, it will help clinicians who practice in urgent care centers with the selection of applicable measures for fulfilling the quality component of MIPS. The specialty set recommended by the two societies includes 12 quality measures. However, clinicians choosing to report the urgent care medicine specialty measure set would only be obligated to report six measures, assuming the number of required measures does not change for the 2019 performance year. UCA will learn whether the urgent care medicine specialty measure set was accepted when the Quality Payment Program proposed rule is issued later this year.

Virtual Groups MIPS Reporting Option for 2018: Deadline December 31st: In November, the Centers for Medicare and Medicaid Services (CMS) finalized that individual clinicians and groups can participate in the Merit-Based Incentive Payment System (MIPS) as virtual groups during the 2018 performance year which begins on January 1.  On Jan. 1, 2017, eligible clinicians began participation in the Quality Payment Program in one of two ways: MIPS or Advanced Alternative Payment Models.

CMS Issues Requirements for 2018: Medicare Quality Payment Program (November 7, 2017): For physicians and other eligible clinicians who choose to participate in the QPP through the MIPS payment pathway, CMS continues participation flexibility, but increases the performance threshold that a MIPS eligible clinician will need to meet to avoid a negative payment adjustment in 2020. Overall, the 2018 program requirements represent a scaling up of the program in anticipation of more rigorous participation requirements in 2019 as required by law.

Nine Steps to Avoid a Medicare Payment Penalty (October 4, 2017): Under the Medicare Quality Payment Program (QPP), physicians, nurse practitioners, and physician assistants who bill for Medicare Part B services have a choice of two avenues to avoid a Medicare payment penalty in 2019: the Merit-Based Incentive Payment System (MIPS) and Advanced Alternative Payment Models (APMs). 

UCAOA Comments on Medicare Quality Payment Program Proposals (August 21, 2017): UCAOA submitted comments to the Centers for Medicare and Medicaid Services (CMS) on August 21 in response to the Agency’s proposed updates to the Quality Payment Program (QPP) for 2018.  

Senator Cassidy Presents Urgent Care Bill to VA Committee (July 11, 2017): Sen. Bill Cassidy (R-LA) spoke in strong support of his legislation, the Veterans Emergency Room Relief Act (S. 1261), a bill embraced by the UCA that will provide relief to the Department of Veterans Affairs’ (VA) overburdened health care system and establish urgent care centers as an important health care access point for our nation’s veterans.

House Passes Medical Malpractice Bill That Faces Tough Road in the Senate (June 28, 2017): The Republican-controlled House of Representatives narrowly passed legislation to limit damages from medical malpractice lawsuits as part of the GOP effort to reform the health care system.

CMS Proposes Quality Payment Program Participation Requirements for 2018 (June 20, 2017): CMS released proposed requirements for physician participation in the Merit-Based Incentive Payment System (MIPS) and Alternative Payment Models (APMs) for the 2018 performance year. 

Freestanding EDs Discussed at Congressional Hearing (May 18, 2017): A U.S. House of Representatives congressional committee held a hearing on the current status of the Medicare program. The Ways and Means Subcommittee on Health Chairman Pat Tiberi (R-OH) asked Mark Miller, PhD, executive director of the Medicare Payment Advisory Commission (MedPAC) to preview their recommendations on freestanding emergency departments. 

New Quality Payment Program Begins on January 1: The performance period for the new Medicare Part B Quality Payment Program (QPP) will begin. While it is not necessary for clinicians to begin participation on January 1st to avoid a negative 4 percent adjustment in 2019, clinicians who are aiming to receive a positive adjustment and bonus payment are encouraged to begin participation as early in 2017 as possible.


UCA State Resources: A listing of state specific resources and descriptions to help you reach out to local entities for further information.

CQ State Track: Member advocacy tool that tracks legislative activity in all 50 U.S. states. 

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