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The California Academy of Family Physicians recognizes that California solo, small and rural practice family physicians have particular needs when it comes to preparing to participate and succeed in the Quality Payment Program (QPP). It is our ultimate mission to guide you through the unique challenges you face and ensure you thrive in the new environment as we know that the extensive reporting required by value-based payment programs can be time-consuming and often demands additional staff and/or technology to complete. Below, is your one stop to CAFP developed guidance for small and rural practice family physicians that specifically highlights applicable rules and opportunities for assistance.

CAFP’s Guide to Technical Assistance for Small, Underserved, and Rural Practices
To help get you started, we have released the Small and Rural Practice Family Physicians’ Quality Payment Program primer. This comprehensive document discusses how QPP affects solo, small and rural practice physicians and outlines readily available, FREE technical assistance.

The Quality Payment Program: Guidance for Small and Rural Practice Physicians Webinar
CAFP hosted the Quality Payment Program: Guidance for Small and Rural Practice
Physicians webinar with health care policy and payment expert, Leah Newkirk, JD and Health
Services Advisory Group (HSAG) representative, David Mittra. Together the two highlighted
how the law specifically applies to and affects physicians in small and rural practice settings and
reviewed the free technical assistance available through HSAG and other resources. If you
belong in either of these settings, CAFP encourages you to download the accompanying slides to reference as you review the video.

Small and Rural Practice Physician Profile
To give family physicians in either a small, solo or rural practice more time to learn how others adjusted to the Quality Payment Program and how they started preparing for MIPS, CAFP has composed short physician profiles summarizing their journey. These profiles are based on extensive interviews with some of our physician leaders and are meant to give a first person perspective of some of the inevitable challenges faced and will highlight potentially useful tools. If you would like to contribute your own story, please contact Conrad Amenta at or (415) 345-8667 to set up an interview.


Dr. Larry Shore is a practicing family physician in San Francisco and an active CAFP member. He works in a small practice with three other family physicians and three midlevel providers. He is mainly concerned about the insufficient reporting capacity of his EMR on quality measures and the potential for that to reduce their MIPS composite score. Read more to see how Dr. Shore prepared to overcome his concerns and report into MIPS.


Dr. Lee Leer is a practicing family physician in Eureka, California and an active CAFP member. After working for 23 years in a small, rural practice, Dr. Leer was forced to make the difficult decision to leave his small group and join a local hospital as an employee. Several changes in the health care landscape drove him to make the switch. Read more Read more to see what Dr. Leer faced through his years of practice.


Dr. Patrick Yassini is solo family physician in Coronado, California and an active CAFP member. Dr. Yassini has a direct primary care practice in which he offers a wide range of integrative therapies. While he does not accept traditional insurance, he does accept Medicare. In fact, 70 percent of his patient panel is made up of Medicare beneficiaries. Read more to learn more about some of the tools Dr. Yassini has employed to report to Medicare.