AttributionPQRS ReportingValue-Based Payment Modifier
May 26, 2015

Provider Network Growth? How to Avoid Unanticipated Medicare VBPM Penalties

Mergers and acquisitions, joint ventures and affiliations—this is the new face of health care, and the trend shows no signs of slackening. If your group has grown and changed significantly through consolidation, you’d best take a second look at your 2013 Quality and Resource Use Report (QRUR). Chances are, it no longer applies to your organization, putting your at risk for significant penalties under the Value-Based Payment Modifier (VBPM). The good news is that CMS has released its Mid-Year 2014 QRURs to all providers, regardless of how many providers are billed under your group’s Tax Identification Number (TIN). Why bother…
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Population HealthRegistry ScienceResearch
May 19, 2015

Population Health: Fact or Fiction?

For the past couple of years, “population health” has become a popular catchphrase.  Everyone is talking about it, adopting it or selling it. But if you ask anyone what it means, you’ll get very different answers. That’s because there seems to be only one point of consensus—we need to focus health care efforts on specific populations. Should you care? I think so, and here’s why: Providers and ACOs are beginning to spend a lot of money on population health, yet no one is measuring the effects of those efforts and whether they actually achieve positive outcomes. Fuzzy Definitions Can Lead…
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AttributionPopulation HealthPQRS ReportingQualified Clinical Data Registry ReportingValue-Based Payment Modifier
May 12, 2015

Prove You’re a Top Tier Health Care Provider: Six Essentials for Your Value-Based Purchasing Game Plan

You know you need to shift your organization toward Value-Based Health Care. It’s a trend that’s here to stay, and you’re deep into planning your strategy. Question is, what’s the right game plan that will enable you to reap financial benefits by proving you’re a top-tier provider that offers quality, cost-effective health care? All too often, providers focus on adopting a reimbursement and delivery model that assumes risk without addressing fundamentals. Remember, this is not just about reorganizing to manage risk without engineering for improvement. While you must take steps to participate in the new Value-Based Health Care models, you…
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AttributionPQRS ReportingQualified Clinical Data Registry ReportingValue-Based Payment Modifier
May 5, 2015

Who Else Cares for Your Patients? How the Wrong Patient Attribution Can Skew Your VBPM

So, exactly who are your patients? Sounds like a silly question. But when it comes to Medicare’s patient attribution methodology, the answer is not obvious. Medicare attributes patients to providers and practices in order to calculate components of the Value-Based Payment Modifier (VBPM). Like it or not, certain patients can be attributed to your practice, even if their conditions are not under your clinical management, skewing your VBPM. If you don’t understand the rules, you risk significant penalties. This is true for all providers, but most apparent in specialty groups. As a Qualified Registry and QCDR that reports all measures…
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