Future of Health CareMedical Decision-MakingMedical EducationPatient EmpowermentPerformance ImprovementQualified Clinical Data Registry Reporting
April 26, 2017

Primary Care Physicians’ Ethical Dilemma: Meet Goals for Patients or Practice Owners?

Primary care physicians are on a collision course with health care consumers—their patients. While trying to deliver best clinical care, they must navigate a competitive business environment that encourages higher spending. The business of health care has undergone rapid consolidation in physician practice ownership. Spurred by the need to compete for patients, use EMR technology and manage within the heavily regulated health care industry, physicians have moved from smaller to larger group practices. Primary care physicians have made this transition faster than specialists by selling their practices, and are now more likely to be employed by a hospital. But this…
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MACRAMerit-Based Incentive Payment System (MIPS)Qualified Clinical Data Registry Reporting
April 5, 2017

Do Centers of Excellence Lose Under New MACRA MIPS Episodic Cost Measures?

Health systems’ Centers of Excellence that attract patients through clinical prowess may be heading for an upset. Under the MACRA MIPS program now entering its first year, physicians will be scored for cost performance in some of the same clinical areas that they have promoted to distinguish their care—and compared against their peers. Since Centers of Excellence are likely to be higher cost in comparison with other providers, associated episodic cost measures may possibly be used to penalize their providers. The impact won’t be felt immediately, however; in 2017 the MIPS Cost component is scored but not calculated in the…
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Alternative Payment Models (APM)Meaningful UseMerit-Based Incentive Payment System (MIPS)PQRS ReportingQualified Clinical Data Registry ReportingValue Modifier
February 28, 2017

How to Turn 2016 PQRS Success into Better Care (and a MIPS Win)

March has arrived. The submission window for PQRS shuts on March 31. It’s the moment of truth for providers, practices and Registries. Are you ready to report, ready to panic or somewhere in-between? It’s probably too late to implement an initiative designed to improve your PQRS measures, but with the right Registry partner, there is still a path to 2016 PQRS success, even if you aren’t “PQRS Ready.” More importantly, if you follow these three steps, you’ll also create a pathway to success in the Quality Payment Program (either through MIPS or an APM)—both by avoiding penalties, as well as…
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MACRAMerit-Based Incentive Payment System (MIPS)Qualified Clinical Data Registry ReportingRegistry Science
February 7, 2017

Roji Health Intelligence’s Roji Registry Earns ONC-Health IT Certification from Drummond Group LLC

Roji Health Intelligence has reached another milestone, enhancing Solutions to help providers achieve better outcomes and lower costs. Roji Registry has earned Office of the National Coordinator for Health Information Technology (ONC-Health IT) 2015 Edition Health IT Module Certification via Drummond Group LLC, an Authorized Certification Body (ACB). See details here. Why ONC-Health IT Certification is Important to Current and Future Roji Health Intelligence Clients ONC-Health IT Certification provides Roji Health Intelligence with additional capabilities for streamlining performance measurement and improvement. This is especially important for the Roji Health Intelligence Qualified Clinical Data Registry (QCDR), which has unique advantages for…
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Future of Health CareMACRAMerit-Based Incentive Payment System (MIPS)Qualified Clinical Data Registry ReportingRoji Health Intelligence
January 17, 2017

Roji Health Intelligence: Chart Your Course for the New Phase in Health Care

With 2017 we are predicting some big changes in how the health care industry moves forward. Having worked with health care organizations for 15 years, we know that most of them are not ready. Roji Health Intelligence was not just a name change for ICLOPS, but a signal that we are ready to help. Roji Health Intelligence Website Signals Evolution of Services Our new website is up and ready. It is light-filled and inviting, for a good reason. We believe the path to change can be collaborative yet still focused on results and real data. We refute contentious and negative approaches…
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Alternative Payment Models (APM)Merit-Based Incentive Payment System (MIPS)PQRS ReportingQualified Clinical Data Registry ReportingValue ModifierValue-Based Payment Modifier
November 29, 2016

PQRS Homestretch: Finish Line In Sight (But You Haven’t Crossed It Yet)

It’s almost time to bid farewell to PQRS (formerly PQRI), and say hello to the Merit-based Incentive Payment System (MIPS). But PQRS hasn’t ended yet; even when it does, financial implications will not be felt until 2018. Those who do not report PQRS are at risk of being penalized twice, once for PQRS and once for the Value Modifier (VM). Those who do report may earn incentives, penalties or be held neutral, depending on cost and quality results. Ideally, you are already using PQRS as a stepping-stone to succeed in the Quality Payment Program, but even if you haven’t, there…
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PQRS ReportingQualified Clinical Data Registry ReportingValue ModifierValue-Based Health CareValue-Based Payment Modifier
November 22, 2016

Improve MAV Audit Success with Expert Data

There are 198 measures available for PQRS Registry Reporting in 2016—seems like there should be enough options to select the most advantageous measures for providers. Unfortunately, however, that’s not the case. Even though there are a whopping 21 measures that could be skipped for each 1 reported, and twice as many National Quality Strategy (NQS) Domains as needed, not everyone will be able to report on 9 measures across 3 Domains (including a cross-cutting measure!). Why is there difficulty in meeting basic reporting requirements? Because measures do not apply to specialties in equal amounts, nor are they evenly distributed within…
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MACRAMerit-Based Incentive Payment System (MIPS)Qualified Clinical Data Registry ReportingValue ModifierValue-Based Health Care
November 8, 2016

Risky Business: How to Make Risk Adjustment Fair and Accurate for Quality Measurement

No two patients are the same. Some are much sicker than others. Obvious? Yes. But this is the fundamental challenge of quality measurement. As public scrutiny of physician performance intensifies via the CMS Physician Compare website, and as outcome comparisons become ever more crucial to Medicare and private insurance reimbursement strategies, finding a fair and accurate way to adjust for risk is critical. Each patient population has its own challenges. Academic medical centers may get the most difficult cases, but solo practitioners see the entire community, and without the infrastructure available elsewhere. For health care to improve for all patients,…
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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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