Roji Intel Blog

Dave Halpert 0
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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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Dave Halpert 0
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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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Theresa Hush 0
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Future of Health CareMACRAMerit-Based Incentive Payment System (MIPS)Performance ImprovementPQRS ReportingQualified Clinical Data Registry ReportingValue ModifierValue-Based Health CareValue-Based Payment Modifier
August 2, 2016

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 only been meeting reporting requirements and have yet to evaluate your performance, you stand to lose more under the tougher requirements of MACRA MIPS next year. We cannot stress this enough: 2016 should be the year to seriously evaluate your performance and create your strategy.…
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Dave Halpert 0
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Alternative Payment Models (APM)MACRAMeaningful UseMerit-Based Incentive Payment System (MIPS)Performance ImprovementPQRS ReportingQualified Clinical Data Registry ReportingValue ModifierValue-Based Health CareValue-Based Payment Modifier
July 26, 2016

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 didn’t register, and are not in an ACO or another program that excuses you from PQRS (beware—this does NOT include Meaningful Use!), you’re still on the hook for PQRS and are locked into reporting at an individual level. Now that the registration deadline has passed,…
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Theresa Hush 1
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Alternative Payment Models (APM)MACRAMeaningful UseMerit-Based Incentive Payment System (MIPS)PQRS ReportingQualified Clinical Data Registry ReportingValue ModifierValue-Based Health CareValue-Based Payment Modifier
June 21, 2016

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 plans. Not only is the wait over, but only about half a year remains until MIPS begins. And the challenges won’t fall evenly across provider groups. Size, specialty and support will weigh heavily into MIPS success. A customized MIPS strategy is your key to avoiding the…
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Theresa Hush 0
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Merit-Based Incentive Payment System (MIPS)PQRS ReportingQualified Clinical Data Registry ReportingValue ModifierValue-Based Payment Modifier
May 24, 2016

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 means that at least 50 percent of eligible professionals billing under one TIN must successfully meet PQRS reporting criteria; Report for providers using a Group Reporting Option (GRPO) in one of three ways: a. GPRO Registry option, by which you select a Registry to perform…
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Dave Halpert 0
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Alternative Payment Models (APM)MACRAMerit-Based Incentive Payment System (MIPS)Performance ImprovementPQRS ReportingQualified Clinical Data Registry ReportingValue ModifierValue-Based Health CareValue-Based Payment Modifier
May 3, 2016

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 deal at stake, including hundreds of millions of dollars in penalties and incentives. Here’s what you need to know about the proposal and how it affects you. And if you have concerns, be sure to speak up during the 60-day comment period! As anticipated, Alternative…
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Dave Halpert 0
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ACO ReportingAlternative Payment Models (APM)Clinical Data RegistryPQRS ReportingValue ModifierValue-Based Health CareValue-Based Payment Modifier
April 5, 2016

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 an Accountable Care Organization (ACO). It’s certainly true that if your ACO reports successfully—and most do—you are not required also to report for PQRS. But before you take the huge organizational leap to forming or joining an ACO, you’d best read the fine print. For…
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Dave Halpert 0
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Future of Health CarePerformance ImprovementPQRS ReportingValue ModifierValue-Based Health CareValue-Based Payment Modifier
March 15, 2016

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 just been decided by CMS, and it’s an eye-popping 15.92 percent on all allowable Medicare Part B charges. Simply put, those groups whose Quality and Resource Use Reports (QRURs) showed 1.0 x AF will earn close to an additional 16 percent incentive payment, more than…
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Dave Halpert 0
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ACO ReportingAlternative Payment Models (APM)Clinical Data RegistryFuture of Health CareMerit-Based Incentive Payment System (MIPS)Value-Based Health CareValue-Based Payment Modifier
March 8, 2016

APMs Are Here and MIPS Is Coming Sooner Than You Think: How to Plan for the Unknown

How do you prepare for a program with yet-to-be-defined rules that will involve larger potential penalties (or incentives)—but requires long term planning? It’s a real quandary, but the time is now to begin thinking strategically about the upcoming Merit-Based Incentive Payment System, or MIPS. MIPS Fundamentals MIPS was created from the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA). The Act succeeded in expunging the looming but flawed “Sustainable Growth Rate” formula, replacing impending cuts with reimbursement tied to Value-Based Health Care. MIPS details may be lacking, but the overall MIPS framework is taking shape. Scheduled to begin on…
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