Future of Health CarePerformance ImprovementQualified Clinical Data Registry Reporting
September 29, 2015

Big Data Analytics v Clinical Data Registry: Which Is Best for Performance Improvement?

A few weeks ago, Epic announced that it would create an unidentified database of patient data for customer research, with a plan that the “Cosmos Research Network” will leverage data for better decisions. There’s been a flurry of activity in recent years to create Big Data in health care. The Clinical Data Registry (CDR) is a variation of the concept, soon to be populated by data from Meaningful Use public reporting requirements. The question: Can both these data engines help performance improvement? The answer depends on a key distinction between Big Data Analytics and the CDR, with important implications for…
Read More
Future of Health CareMerit-Based Incentive Payment System (MIPS)Performance ImprovementPQRS ReportingQualified Clinical Data Registry ReportingValue-Based Payment Modifier
September 22, 2015

Medicare’s MIPS: The Not-So New Face of Value-Based Care

Rumors that PQRS and VBPM have died may be wishful thinking, but are far from true. Value-Based Care is here to stay, even as Medicare’s programs evolve. You still have a chance to help shape those initiatives before they become law. So it’s well worth your time now to learn all about Medicare’s newest program, MIPS. In 2019, Medicare will phase in the Merit-Based Incentive Payment System (MIPS). The 2016 reporting year will form the basis for the final Value-Based Payment Modifier (VBPM) and PQRS payment adjustments, to be applied in 2018, with MIPS to begin the following year. But…
Read More
ACO ReportingFuture of Health CarePQRS ReportingQualified Clinical Data Registry ReportingRegistry ScienceValue-Based Payment Modifier
September 15, 2015

No More Status Quo: How the New CDR Will Change Health Care

As CMS streamlines its Value-Based Reimbursement programs, the pressure is on for providers to participate. A better foundation is needed to support those changes, so providers can actually succeed. And Medicare’s expansion of Clinical Data Registries (CDRs) may just be the answer. CDRs could be the tipping point for transforming health care. Here’s why: With better capabilities for performance measurement, more comprehensive databases, and expertise for more advanced outcomes analyses and research, CDRs can provide tools that have been missing for all stakeholders—providers, health plans and consumers. What’s a CDR and Why Is It Different? The Clinical Data Registry has…
Read More
PQRS ReportingQualified Clinical Data Registry ReportingValue-Based Payment Modifier
September 8, 2015

Know Your Risk Under VBPM: Your Medicare Revenues Are at Stake

Although Medicare has been increasing the pressure on providers to prepare for value-based health care, we still encounter many providers who are unaware or confused. Big clue: we see all too many large provider organizations that are developing RFPs for PQRS reporting without also including an evaluation of their risk under the Value-Based Payment Modifier (VBPM). If you are unaware that successful PQRS reporting in 2015 can still result in an even greater performance penalty under the VBPM, up to 4 percent of your 2017 revenues, this post is for you. The VBPM is a calculation by Medicare that compares…
Read More
Alternative Payment Models (APM)AttributionMerit-Based Incentive Payment System (MIPS)Qualified Clinical Data Registry ReportingValue-Based Payment Modifier
September 1, 2015

Mastering MSPB: How “Episode” Care Calculations Make or Break Your Revenues

The whole may be greater than the sum of its parts—but how those parts each contribute to the whole is key to a new Medicare calculation of episode costs. If you aren’t paying attention to the total cost of an entire “episode” of care for your patients—including that rendered by others—your future revenues may take a hit. Enter Medicare Spending Per Beneficiary (MSPB), a component of CMS’s Value-Based Payment Modifier (VBPM) calculations that is crucial to your bottom line. MSPB is a measure of charges per episode of care that looks at costs immediately prior to, during and following a hospital…
Read More