Value-based purchasing of health care services, risk adjustment payments to health plans, and payment for meeting performance measures are not new, but they are growing and evolving. Physician practices are increasingly finding it necessary to use data to demonstrate the quality and value of care provided to patients, especially groups of patients covered under the same health plan or provider network. Data can be important in gaining acceptance into payer networks, achieving high ratings assigned by payers to physicians and other qualified health care professionals (QHPs), contesting inaccurate payment or ratings, and negotiating contracts.

This article addresses documentation necessary to demonstrate quality and value. Topics include the following:

To show quality and value, physicians and QHPs must fully document the conditions addressed and/or the conditions affecting management, services rendered, and, when applicable, the reason that a screening or service was not provided (eg, not screening for depression in a patient...

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