Alternative Payment Models (APM)MACRAMerit-Based Incentive Payment System (MIPS)Qualified Clinical Data Registry ReportingValue-Based Health Care
October 28, 2016

The MACRA Final Rule: On Your Mark, Get Set . . . Transition!

The Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) has (among other things) repealed the Sustainable Growth Rate and incorporated quality measurement into payment, steering away from traditional Fee for Service payments. In other words, revenues are being tied to quality, rather than volume. The Quality Payment Program (QPP) defined within MACRA offers two methods of participation: Merit-Based Incentive Payment System (MIPS) Advanced Alternate Payment Models (Advanced APMs) The Final Rule (CMS-5517-FC: “Medicare Program; Merit-based Incentive Payment System (MIPS) and Alternative Payment Model (APM) Incentive under the Physician Fee Schedule, and Criteria for Physician-Focused Payment Models”), released on October…
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MACRAPerformance ImprovementQualified Clinical Data Registry ReportingValue-Based Health Care
October 25, 2016

Your Wish List for MACRA Performance Improvement Technology

Even as CMS has eased the transition to MACRA with the Final Rule published on October 14, managing under Risk remains a core goal. The best way to prepare your organization? Develop MACRA Improvement Activities (formerly CPIAs), the training ground for managing under Risk. The MACRA Improvement Activities cover all of the processes and root causes of health care cost increases, and Medicare wants you to address them. Hint: they’re scoring your work. While the MACRA requirements are now superficially easy to meet—attest to at least one Performance Improvement Activity—the reality will be very different if you are really preparing for…
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Alternative Payment Models (APM)MACRAMerit-Based Incentive Payment System (MIPS)Value-Based Health Care
October 18, 2016

Don’t Be Fooled: MACRA Final Rule Still Favors Quality Improvement Leaders

In case you haven’t yet had a chance to digest all 2,400 pages of the MACRA Final Rule, announced by CMS on October 14, here’s the main takeaway: Phasing in the implementation process, CMS has made it much easier to avoid penalties, at least in the short run. But those who push the boundaries of quality improvement remain the biggest winners. Three Levels of Participation in MIPS Quality Component The Quality component now defines varying levels of participation (“Pick Your Pace”), holding harmless all who submit data for MIPS. There are three levels of participation: Test Submission Partial Submission Full…
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Future of Health CareMedical Decision-MakingPerformance ImprovementRegistry ScienceResearchValue-Based Health Care
October 11, 2016

Physician Culture Must Transition from Defensiveness to Performance Improvement

Physicians undergo long and arduous training, with good reason. Lives are at stake. Learning to make the correct diagnosis, to expertly perform the appropriate procedure and to properly treat conditions is essential. Mistakes or flaws are scrutinized and not tolerated. Being wrong may cause greater harm to the patient—and lead to malpractice litigation. In short, physician culture places a premium on individual performance and responsibility. Steeped in those values, most physicians take great pride in the quality of care they deliver to patients, in the examination room or the surgical suite. Teams who provide specialized services, such as Emergency Departments,…
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Alternative Payment Models (APM)Future of Health CareMACRAMerit-Based Incentive Payment System (MIPS)Performance ImprovementValue-Based Health Care
October 4, 2016

Improve Your Risk Readiness With Physician-Driven MACRA CPIA Innovation

CMS is pushing providers to accept Risk under Alternative Payment Models (APMs), and they’re sweetening the pot with incentives. But for the vast number of providers who will participate in MIPS because they don’t participate in risk-based APMs, the path to reward is murky. That’s because many Health Systems have a hard time visualizing how Performance Improvement with CPIAs can create savings under ACOs, the biggest APM model. Here’s the key: innovation that engages physicians. Historical Performance Improvement Often Leaves Out Physicians For most Health Systems, it’s rare for physicians to actively participate in Performance Improvement initiatives. There are two…
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