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 […]
Large Practice PQRS Reporting: Act Now Before GPRO Self-Nomination Deadline
If you’re still on the fence about reporting PQRS as a Group or Individual for 2016, it’s decision time. With the June 30 deadline for Group Reporting self-nomination just over a month away, you need to check out your options now or risk expensive reporting failures. These are your choices: Report for providers individually, which […]
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 […]
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 […]
Still Not Sure of PQRS-VBPM? You Just Gave Your Competitor a Huge Bonus
If you still need a good reason to meet all PQRS requirements and improve your quality tiering under the Value-Based Payment Modifier (VBPM or Value Modifier), listen up: Failure to do so means your penalty will end up in your competitor’s pocket. Not only that—the 2016 Value Modifier Adjustment Factor (AF) for incentive payments has […]
Don’t Hit the Medicare Revenue Wall: What You Must Know About 2016 PQRS-VBPM Benchmarks
What will it take for health care providers actually to focus on improving patient outcomes, while keeping costs under control? CMS has structured quality reporting under the Value-Based Payment Modifier (VBPM) to reward providers who surpass PQRS measure benchmarks, and penalize those who lag behind. But inherent in the new quality tiering is a serious […]
Expanding Your ACO: The Best Recruiting Strategy for Bigger ACO Savings
Whether your ACO is in its infancy or is established and growing, you’ve probably had to make some difficult choices about which groups to include—and exclude. Your ACO’s success is almost entirely driven by your ACO network’s participating providers (and their patients). They provide the care and generate beneficiary costs, and help to ensure better […]
Want Real Performance and Outcomes Improvement? Track Interventions and Results Over Time
Time will explain it all. He is a talker, and needs no questioning before he speaks—Euripides For many providers, reviewing performance data is just another distraction from practicing medicine, rather than a valued tool for making better medical decisions. And who can blame them? Performance or outcome data reviewed in isolation, as static results, aren’t […]
2016 Medicare Final Physician Payment Rule: What You Must Know
CMS’s push toward value-based care and performance improvement leaves no more room for doubt. In a hefty 1,358 pages, the 2016 Medicare Final Rule expands the role of Qualified Clinical Data Registries for PQRS reporting, dovetailing with the Specialized/Clinical Data Registry component in the Meaningful Use Rules. Both methods place the focus squarely on how […]
ICLOPS Case Study: VBPM Consultation Lifts Specialty Group’s Quality Tier and Medicare Revenues
Medicare’s Value-Based Health Care programs aren’t just about penalties. You can also earn a reward. Case in point—an ICLOPS orthopedic client recently asked The Big Question: Are there really incentives to be earned through Medicare’s Value-Based Care? With the release on September 9 of the Annual Quality and Resource Use Reports (QRURs), the answer is a […]