The new Medicare physician payment system—the Quality Payment Program (QPP)—includes two possible pathways for surgeons to participate. In this short video, Christian Shalgian, American College of Surgeons (ACS) Director of the Division of Advocacy and Health Policy in Washington, DC, explains these two pathways and why it is critical for surgeons to become familiar with the changes ahead in Medicare physician payments. It is important to note, Medicare payments to surgeons in 2019 will be based on surgeons’ performance in quality programs in 2017.