AttributionPQRS ReportingValue-Based Payment Modifier
August 25, 2015

How to Boost Your VBPM with ICD-10

With five weeks until ICD-10 becomes official, take note: Your transition strategy must include PQRS and the Value-Based Payment Modifier (VBPM). Neglecting VBPM in your short-term plan may lead to long-term penalties. That now goes for everybody, whether you helm an Academic Medical Center or run a small practice. October 1, 2015, marks the starting date of the new coding set for diagnoses and inpatient procedures. ICD-10’s increased specificity dovetails with how medicine is practiced today, versus the 36-year-old ICD-9 coding. Given a choice between implementation and lost revenues, practices will have no option but to make the transition. As…
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ACO ReportingPQRS ReportingQualified Clinical Data Registry ReportingValue-Based Payment Modifier
August 18, 2015

Radiologists’ Tool Kit: How to Succeed in PQRS and VBPM

When it comes to PQRS reporting, it’s not easy being a radiologist. How can you fulfill PQRS reporting requirements and avoid jeopardizing future value-based payments? Many radiologists have found themselves backed into a PQRS corner—not enough measures to report, and those measures that can be reported have some tricky requirements. Similar to anesthesiologists, radiologists practice in a variety of settings and perform different types of procedures, according to sub-specialty. Depending on the procedures you perform, the vast majority of PQRS measures may not be applicable to you—not only are they clinically irrelevant, but you couldn’t report them even if you…
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PQRS ReportingQualified Clinical Data Registry ReportingValue-Based Payment Modifier
August 11, 2015

Medicare’s 2016 Proposed Rule: What Do You Need to Know?

Is PQRS dead? That’s the question we’ve been hearing, in the wake of the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA), which outlined a new program for merit-based payments. With the release of the 2016 Proposed Rule, the answer is a resounding “No.” The Proposed Rule is exactly that—proposed, rather than final. Nevertheless, historically speaking, there is little deviation between the Proposed Rule and the Final Rule, and so those with a stake in the matter (which presumably includes you, if you’re reading this), should begin digesting these 813 pages to see the direction the program will take…
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ACO ReportingFuture of Health CarePopulation HealthQualified Clinical Data Registry ReportingRegistry ScienceResearchValue-Based Payment Modifier
August 4, 2015

ACOs and the Referral Revolution Part 2: How to Align Objectives and Referral Practices

There’s no getting around it. Disruption in referrals under new Value-Based Health Care programs will upset both primary care and specialty practices under any change scenario. Physicians with historical relationships will undoubtedly resent an edict to redirect referrals, if they don’t understand or believe comparative data on cost and quality. On the other side of the equation, physicians who accept that aligning referrals with outcome data is part of being in an ACO will object if they see that referrals are driven, instead, by physician employment status. Every participant in an ACO must eventually accept that achieving shared savings will…
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