No way out. That’s the message of the CMS 2023 Final Payment Rule regarding APP quality reporting for ACOs. ACOs hoping for a reprieve to avoid all-patient quality reporting did not get it. APP Reporting will go forward by 2025, and ACOs must aggregate the patient data from provider systems to enable it. CMS has […]
The Real Registry Advantage for ACOs Reporting Via APP: 5 Myths Debunked
The clock is winding down on the CMS Web Interface, and the reality of mandatory quality reporting via the Alternate Payment Model Performance Pathway (APP) for ACOs in 2022 is setting in. In order for ACOs to develop and execute their APP quality reporting plan in time to avoid catastrophe, it’s imperative to begin evaluating […]
The Interim ACO Rule Explained: A Pause, Not a Reprieve
As the coronavirus pandemic continues to upend health care in the U.S., pressure has mounted on CMS to adjust its efforts to drive providers to adopt risk. In response, at the end of last week CMS announced a carve-out of COVID-19 patient expenses from certain reporting requirements. In this round, ACOs were on the receiving […]
Can Health Care Stay the Course of Reform Amidst Uncertainty?
With the new year finally here, health care organizations need to know: How should you proceed amidst uncertainty about Medicare policy, including Value-Based and Risk programs initiated by the Obama administration? In the crosshairs are the new, complex Quality Payment Programs under MACRA, including both MIPS and Alternative Payment Models (APMs) such as ACOs. Although […]
ACO Under MACRA? Five Essential Takeaways
While Accountable Care Organizations (ACOs) get a little boost under proposed MACRA Rules, this comes at a price. MACRA provides a 5 percent bonus and a MIPS reporting exemption for providers who participate in an Advanced Alternative Payment Models, the most common being a Stage 2 or 3 ACO—if and only if they assume a […]
MIPS v APM: Which Is Your Best Bet?
If you’ve been watching the signals from CMS, you undoubtedly know by now that the current reimbursement structure under Medicare will end, to be replaced by a Quality Payment Program (QPP) that holds providers at risk for resource use and quality. The ensuing choices, however, are confusing. Providers can select one of two QPP tracks: […]
Proposed MACRA Rules: Your APM Strategy for Risk Readiness
If you chose not to participate in Medicare ACOs or Bundled Payments in recent years, CMS is planning to change your mind. Proposed MACRA Rules reveal a complex carrot-and-stick approach to inducing providers into risk models. Make no mistake: it’s just a matter of when, not if, you participate in one of the Alternative Payment […]
Your MACRA Prep for APMs: Learn from ACO Failures
Many provider groups are suddenly realizing they need to understand how a Medicare risk model will impact their operations and revenues. With CMS pushing providers to embrace Alternative Payment Model (APM) risk models under Proposed MACRA Rules, they should be nervous. Although prior APMs such as ACOs did not approach the levels of risk under […]
Your Health Care IT Investments: How to Purchase for Performance Improvement
Health care technology (HIT) is frequently oversold. That may be a surprising message coming from a Registry CEO, but it’s the truth. In the quest for answers, too many providers search for a system that can “do it all,” a dream technology that exists, well, only in your dreams. There is intense pressure on providers […]
If Your Solution to PQRS Reporting Is an ACO, Think Again
Problems with PQRS reporting this year? As a Registry that works with groups ranging from Academic Medical Centers to solo practitioners, we’ve seen the whole gamut of issues. While there are no quick and easy solutions (sorry), the biggest myth we’re hearing this year is that you can solve all your PQRS problems by forming […]