With the CMS announcement last week that the final MACRA Rules will let providers pick and choose activities—or even delay requirements—2017 implementation is now a toss-up. Will providers double down on efforts to meet the MACRA standards in 2018? Or, will eased deadline pressure reverse momentum within health care systems? There are many valid reasons […]
Back to School: Your Post-MACRA Study Guide for QPP Success
Back to school. That phrase prompts memories of making new friends (and catching up with old friends); carts full of notebooks, binders and pens; new classes; and, of course, abject terror. As the summer sun sets on PQRS, the Value Modifier (VM) and Meaningful Use (MU), it’s time for all of us to get into […]
Personalized Medicine v Population Health: Opposites or Complements?
If personalized medical care is the goal, how does that fit with the concept of “population health,” the darling of the health care industry’s drive toward better results and lower costs? Are these two concepts really at odds, or do they work in tandem? This is not a rhetorical question; in the current environment of […]
Can MACRA Help Patient-Centered Medical Homes Succeed?
The concept of a Patient-Centered Medical Home (PCMH) fits neatly into Value-Based Health Care: patients who are well should incur lower costs. And, if primary care providers help patients who are not well to manage chronic diseases and better navigate the system, outcomes and costs should also improve. But those results are not yet proven. […]
Use PQRS 2016 Reporting to Prepare for MACRA MIPS
In the last year of PQRS reporting, you may be tempted to take it easy and complete the bare minimum of reporting requirements. But don’t stick your head in the sand. First, PQRS and Value Modifier (VM) penalties are still alive and strong in 2016 and will affect your revenues in 2018. Second, if you’ve […]
Closing the Book on PQRS (and Opening the MACRA Sequel)
Did you receive your confirmation email from the Physician Value Help Desk that your TIN was successfully registered for Group Practice reporting? If you did, which method did you select? Whether Registry, QCDR, EHR-Direct or the CMS Web Interface, you are officially locked into that choice, and it’s too late to back out. If you […]
MACRA Match-up: How EHR Source Data Will Benefit Registry Research
At the core of MACRA and MIPS requirements, Electronic Health Record (EHR) source data will soon become a key component for Registry research. Specifically, Clinical Performance Improvement Activities (CPIAs) are a required component of MIPS. Performance improvement efforts will no longer be optional. Quality data will be essential. EHRs present an excellent data resource, but […]
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: […]
3 Ways Proposed MACRA Rules Revive Health Systems’ Clinical Integration Programs
Clinical Integration in medium to large Health Systems just received a nice push from the federal government’s Proposed Rules for MACRA. Health Systems trying to market quality-based physician and hospital networks systems— especially those with both employed and private physicians—should take note. This opportunity for Health Systems to bridge Medicare and private health plan quality […]
Know the F.A.C.T.S.: 2016 Proposed MACRA Rule Highlights
Just over a year since the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) passed, the new Proposed MACRA Rule was released on April 27. Now we finally have some details on how Fee For Service will yield to reimbursement through value. There’s a lot to digest in this hefty rule and a great […]