Alternative Payment Models (APM)Merit-Based Incentive Payment System (MIPS)Qualified Clinical Data Registry ReportingValue-Based Health Care
July 25, 2018

The Proposed 2019 Quality Payment Program (QPP) Rule: What You May Have Missed

Whoever said bureaucracy doesn’t foster change did not anticipate CMS’s Proposed Rule for the Quality Payment Program (QPP), 2019 performance year version, released on July 12. While the familiar overarching structure of MIPS remains, there are a number of revisions that activate newly developed policies. These include “Patients Over Paperwork” and “Meaningful Measures” efforts that CMS initiated in 2018 to streamline the requirements-heavy MIPS program. To be honest, there are some rough patches within the wrangling of old and new MIPS provisions in the 1,473 page 2019 Medicare Physician Schedule Proposed Rule, set to be published in the Federal Register…
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Future of Health CareMedical Decision-MakingPerformance ImprovementQualified Clinical Data Registry ReportingValue-Based Health Care
January 17, 2018

Time Out! How Strategic Pauses Can Enhance Medical Decision-Making to Improve Outcomes 

Health care providers are under increasing pressure to improve outcomes for patients with chronic conditions. There is pressure to meet quality measures, to establish programs that improve outcomes, to decrease costs for these conditions (utilization as an outcome)—or a combination of goals. At issue: what works, what is affordable, what is acceptable to patients and clinicians. The answers are elusive because there are many factors involved in the care of patients who have numerous chronic conditions, co-morbidities and medications, as well as multiple healthcare professionals providing their care. Adding to this complexity, any outcomes improvement for patients with chronic conditions…
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Merit-Based Incentive Payment System (MIPS)Performance ImprovementQualified Clinical Data Registry ReportingValue-Based Health Care
November 29, 2017

Convention Lesson: MIPS Improvement Activities Are Woefully Misunderstood

With only a month left of 2017, practices should be wrapping up their Improvement Activities. MIPS requires at least 90 consecutive days of participation in order for a group or clinician to attest that an Improvement Activity is complete—meaning that the last day to start was October 2. The Improvement Activity portion of MIPS is the only component that is not a direct descendant of a previous program, increasing the challenge of implementation. Recently, we attended a national conference for those in healthcare practice and administration; one of our goals was to learn more about how practices were adapting to…
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MACRAMerit-Based Incentive Payment System (MIPS)Qualified Clinical Data Registry Reporting
September 6, 2017

October 2 Is Almost Here: Are You MIPS-Ready?

Calendar check! October 2, the last chance to start your continuous 90-day participation in MIPS, is nearly here. Those who meet minimum standards in the “Pick Your Pace” transition year will avoid a whopping 4 percent penalty on their 2019 Medicare Part B reimbursements. Those who exceed these requirements and perform strongly in MIPS stand to earn incentive payments on top of the regular reimbursement schedule. To make sure that you’re among those who will earn incentives (or at least avoid penalties), take an opportunity to review MIPS requirements, assess what’s in place and close the remaining gaps. What Do…
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Alternative Payment Models (APM)Future of Health CareMACRAMerit-Based Incentive Payment System (MIPS)Performance ImprovementQualified Clinical Data Registry ReportingValue-Based Health Care
August 16, 2017

How to Evolve MACRA MIPS Quality Reporting for Better Physician and Patient Value

Critics are pushing back against Medicare quality reporting, deeming it burdensome and time-consuming to meet confusing quality measures. One survey asserts that barely a majority feel knowledgeable about MACRA or prepared to achieve long-term success. Indeed, CMS is pulling back on program requirements, with the stated desire of making it easier for physicians. So, here's what should be examined—especially when discussing Value-Based Health Care: Does MIPS Quality Reporting meet the benefit test for the effort expended by physicians and their staff? If the point of Quality Measurement and Reporting is to improve care for patients, can it fulfill that potential?…
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Merit-Based Incentive Payment System (MIPS)Performance ImprovementQualified Clinical Data Registry ReportingValue-Based Health Care
August 2, 2017

Why Real Improvement Pays in Your MIPS Improvement Activities Strategy

What separates MIPS from its quality program predecessors? On the Quality Payment Program website, the only component that isn’t a reincarnation of a previous program is the Improvement Activities (IA) category. Although the IA category has a smaller weight than the Quality category, it has the potential to be just as important, if not more so for your composite MIPS score. How can 15 points compare to 60? The answer lies in the way in which those 60 points are earned. It also derives from a fundamental flaw of CMS quality reporting initiatives, to date. The Problem: The Focus On…
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Alternative Payment Models (APM)Clinical Data RegistryMerit-Based Incentive Payment System (MIPS)Qualified Clinical Data Registry ReportingValue-Based Health Care
June 28, 2017

10 Takeaways from the Proposed Rule for MIPS and APMs Year 2

We are already more than halfway through the initial year of Medicare’s new Quality Payment Program, which includes MIPS and APMs. Yet already we are seeing some changes from the new administration that will relax requirements for providers, eliminating the need for some to participate and making quality reporting, in particular, easier. Regardless of how Medicare plays these rules, top providers should maintain a strong strategic focus on Value-Based Health Care initiatives that emphasize performance improvement in cost and quality. Even as Medicare may step back from the leadership role it has taken in this arena, private insurance and employers…
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Merit-Based Incentive Payment System (MIPS)Qualified Clinical Data Registry ReportingValue-Based Health Care
June 14, 2017

Best Practice MIPS Quality Reporting: QCDR Group with Individual Accountability

The “transition” phase of the Merit-Based Payment System (MIPS) is half over, and so, too, is the time needed to prepare for the full rollout in 2018. Yet during the 2017 MIPS “transition” year, many providers are still trying to pigeonhole MACRA’s MIPS into the previous quality program, PQRS. That choice may have worked for simple quality reporting, but it doesn’t work for MACRA’s more comprehensive approach. Among other things, it overlooks a key decision—whether to base quality reporting on group practice or individual provider results. The problem is this: MIPS is not PQRS. It is a full-fledged Value-Based Health…
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MACRAPerformance ImprovementQualified Clinical Data Registry Reporting
May 31, 2017

How to Improve Patient Outcomes with a Multi-Specialty QCDR

Care coordination and HIT interoperability are touted throughout the healthcare world as “must haves” for any provider, practice or health system. The reason is simple: information from multiple sources helps providers and patients to make informed clinical decisions and provide better care. A key pillar in any program that quantifies whether providers are “meaningfully using” their EHRs is the ability to send and receive information on a specific patient. If that’s true at the point of care, doesn’t it make sense that performance measurement and improvement would benefit from the same treatment? Qualified Clinical Data Registries (QCDRs) were created specifically…
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Alternative Payment Models (APM)Merit-Based Incentive Payment System (MIPS)Qualified Clinical Data Registry ReportingValue-Based Health Care
May 17, 2017

Increase MIPS Versatility and Results with an ONC-Health IT Certified QCDR

Providers focusing on MACRA in 2017 have a menu of choices for implementation—perhaps even too many. But don’t overlook this option for meeting requirements for MIPS (or preparing for an Alternative Payment Model or APM): a Qualified Clinical Data Registry (QCDR). And make sure that your review of the QCDR option focuses on the top tier. That means your QCDR should be both ONC-Health IT Certified and have capabilities that go beyond quality reporting. There is a growing recognition of the unique role that clinical registries may play in improving outcomes over time, and related benefits. CMS has reinforced that…
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