The Medicare Access and CHIP Reauthorization Act (MACRA) of 2015, created the Quality Payment Program (QPP). The QPP streamlined multiple quality programs under the Merit-based Incentive Payment System (MIPS) including existing payment programs that ended 12/31/18: (1) Physician Quality Reporting System (PQRS); (2) Value-based Payment Modifier (VBM); and (3) Medicare Electronic Health Record (EHR) Incentive Program. MIPS is intended to rewards clinicians for value over volume.