As part of the MACRA legislation that eliminated the problematic “Sustainable Growth Rate” (SCR) payment update mechanism, CMS combined three legacy incentive systems (meaningful use IT implementation, PQRS quality measure and the cost-based payment adjustment) into the QPP program for the large majority of clinicians (physicians, chiropractors, nurse specialists, physician assistants, clinical nurse midwives, podiatrists).

SURS practices include groups with 15 or less clinicians, HRSA identified shortage areas and federally designated rural zip codes. Many small groups are urban or suburban specialty practices and, thus, the practice diversity of this audience is large.

Also, the SURS clinicians participate in the Merit-based Incentive Payment System (MIPS) as opposed to the alternative Advance Alternative Payment Methods (APMs) where clinician groups take both upside and downside financial risk with Medicare beneficiaries.


Currently, Cynosure provides strategic development of the national support structure for QPP-SURS, is the lead liaison with the medical specialty societies and supports the monthly Learning and Action Network webinars as the facilitator.