David Nilasena, MD, MSPH, MS


 

 

 

Dr. Nilasena is the Chief Medical Officer for the U.S. Centers for Medicare & Medicaid Services’ Dallas Regional Office. He has been with the agency since 1995. He is the regional lead for the agency’s Value-Based Purchasing initiatives, including quality reporting and pay for performance programs in hospitals, ambulatory surgical centers and ambulatory care settings. He is also a lead contact for the HITECH EHR Incentive Programs and the Quality Payment Program (QPP) and is also part of the regional team implementing the Health Insurance Marketplace. Dr. Nilasena has been the CMS lead for national quality improvement efforts in acute myocardial infarction, heart failure and stroke. He has served as a clinical and technical consultant to Quality Improvement Organizations and End Stage Renal Disease Networks in CMS Region 6.   Dr. Nilasena received his medical degree from the University of Texas Health Sciences Center at San Antonio. Following an internship in internal medicine at the Oklahoma University Health Science Center, he completed a two-year research fellowship in immunology at the Oklahoma Medical Research Foundation. He completed residency training in general preventive medicine and public health and a fellowship in general internal medicine and medical informatics at the Veterans Affairs Medical Center in Salt Lake City, UT. Dr. Nilasena has masters of science degrees in both public health and medical informatics from the University of Utah. He is board certified in general preventive medicine/public health.  

The CMS Quality Payment Program: Year 2

The Transforming Clinical Practice Initiative is designed to help clinicians achieve large-scale health transformation. The initiative is designed to support more than 140,000 clinician practices over the next four years in sharing, adapting and further developing their comprehensive quality improvement strategies. The initiative is one part of a strategy advanced by the Affordable Care Act to strengthen the quality of patient care and spend health care dollars more wisely. It aligns with the criteria for innovative models set forth in the Affordable Care Act.

Objectives:
1. To know which clinicians are eligible to participate in the QPP.
2. To understand the reporting requirements for each of the four categories in MIPS.
3 To understand how the MIPS categories are scored and how the final score determines future payment adjustments.
4. To learn the benefits of participation in an Advanced APM.