Listen now (33 mins) | Listen Now On November 1st, the Centers for Medicare and Medicaid Services (CMS) published the agency's final 2020 Quality Payment Program (QPP) rule that announced beginning in 2021 CMS will begin instituting MVPs, or Merit-based Incentive Payment System Value Pathways. These value pathways will be created to financially incent and reward, as CMS states, “high value clinicians.” This means CMS will begin to measure and financially reward Medicare physician performance based on value or spending efficiency defined as outcomes achieved relative to spending. MVPs may prove to be a significant Medicare payment policy reform. This is because while Medicare program officials have implemented numerous "value-based payment" programs and demonstrations since the passage of the 2010 Affordable Care Act, these arrangements financially reward either quality - or - reduced spending growth, they do not reward “value” or spending efficiency. In addition, as recently noted by Harvard’s Ashish Jha and his colleagues in a October 9th JAMA "Viewpoint" essay, these current "value-based payment" programs have not had large effects on quality improvement. (Listeners may recall I discussed measuring for health care value or spending efficiency with University of Michigan Professor Andrew Ryan this past May 11th and in later May posted on the podcast website a related essay I wrote for Bloomberg Law.)