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 […]
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: […]
Succeed Under MACRA Medicare: How to Meet CPIAs for Full Credit in MIPS
Although many parts of MACRA’s MIPS continue Medicare’s existing quality programs, Clinical Performance Improvement Activities (CPIAs) forge a new direction. CPIAs are one of four MIPS components that practices must meet in order to obtain full reimbursement from Medicare. Forward planning is essential. It takes time to strategize and implement performance improvements, including partnerships and […]
What’s the Score? Decoding the MIPS Scoring Methodology
CMS is calling MIPS the “First Step to a Fresh Start.” When it comes to scoring, that’s an understatement. Although MIPS’s foundations are rooted in existing programs, the MIPS algorithm is a significant departure from today’s quality, cost and health information technology scoring. Not only new, this scoring methodology is complex. Providers will receive one […]
MACRA Medicare: Customize MIPS Strategy to Your Practice’s Attributes
Under MACRA Medicare’s Proposed Rules, CMS anticipates that as many as 90 percent of providers will be part of MIPS’s first year, beginning January 1, 2017. That includes providers in ACOs that don’t bear enough risk for exemption, providers who reported PQRS and Meaningful Use, as well as those who did nothing, “waiting out” Medicare’s […]
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 […]
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 […]
Proposed MACRA Rules Boost QCDR Development
One of the promises fulfilled by the new Proposed MACRA Rules, released April 27, is to position the Qualified Clinical Data Registry (QCDR) front and center. In fact, the Rules place the QCDR on par with the EHR in the spectrum of Health Care Information Technology (HIT) and give it special emphasis in Performance Improvement. […]