Roji Intel Blog

Dave Halpert 1
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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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Dave Halpert 0
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MACRAMerit-Based Incentive Payment System (MIPS)PQRS ReportingQualified Clinical Data Registry ReportingValue Modifier
June 14, 2016

Don’t Miss GPRO Deadline: Choose (and Register) by June 30

For many, June 30 means the fiscal year is coming to its end. It also means the deadline for self-nominating for the Group Practice Reporting Option for PQRS looms near. Why does it matter? Because your selection (or lack thereof) has the potential to substantially impact your budget in 2018, and the GPRO registration deadline is June 30. Millions of dollars are at stake. Failing to report for PQRS means that CMS will hold back 6 percent of all Medicare Part B reimbursements in 2018—a 2 percent penalty for not reporting PQRS, plus a 4 percent penalty for the Value…
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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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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 ReportingAttributionClinical Data RegistryMeaningful UsePQRS ReportingQualified Clinical Data Registry ReportingValue-Based Payment Modifier
November 17, 2015

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 outcomes change over time, across all patients. Tracking outcomes and measuring improvement are no longer optional. Here’s what you need to know: QCDRs Get GPRO Submission Status As expected, the differentiation between the Final Rule and the Proposed Rule is minor; the most important change for…
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Dave Halpert 0
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PQRS ReportingQualified Clinical Data Registry ReportingValue-Based Payment Modifier
October 13, 2015

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 resounding “Yes.” At its core, the Value-Based Payment Modifier (VBPM) is a simple proposition: Those who are able to demonstrate higher quality care at a lower cost than other groups are rewarded, while those who can’t are penalized. The rewards come from the pool of…
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Theresa Hush 0
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ACO ReportingFuture of Health CarePQRS ReportingQualified Clinical Data Registry ReportingRegistry ScienceValue-Based Payment Modifier
September 15, 2015

No More Status Quo: How the New CDR Will Change Health Care

As CMS streamlines its Value-Based Reimbursement programs, the pressure is on for providers to participate. A better foundation is needed to support those changes, so providers can actually succeed. And Medicare’s expansion of Clinical Data Registries (CDRs) may just be the answer. CDRs could be the tipping point for transforming health care. Here’s why: With better capabilities for performance measurement, more comprehensive databases, and expertise for more advanced outcomes analyses and research, CDRs can provide tools that have been missing for all stakeholders—providers, health plans and consumers. What’s a CDR and Why Is It Different? The Clinical Data Registry has…
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Dave Halpert 0
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ACO ReportingPQRS ReportingValue-Based Payment Modifier
July 7, 2015

Anesthesiologists’ Best Practices: How to Succeed with Medicare PQRS and VBPM

Anesthesiologists across the country are coping with a unique PQRS challenge. Different procedures and settings may mean that some practices do not have the requisite number of measures to meet requirements. Other groups will have enough measures, but the choices may not be obvious. When you have up to 6 percent of your Medicare Part B revenues at risk, you cannot afford to take that chance. Read on to learn how to make the best reporting decisions for your anesthesiology group and avoid Medicare penalties. Like Orthopedists, your specialty focus inherently limits your relevant PQRS measures—except that for Anesthesia, the options are…
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Theresa Hush 0
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Population HealthPQRS ReportingQualified Clinical Data Registry ReportingValue-Based Payment Modifier
March 24, 2015

PQRS 2014 Last Minute Checklist: What You Can and Can’t Do Now

  With just a few days to go before the final reporting deadline, it’s time to cross the t’s and dot the i’s on PQRS 2014. There may be a few practices still trying to put together a reporting program, but almost everyone using a Registry and who has done the work is ready to report. Here are the top five things you can and should do before your Registry is ready to hit “Submit”: Check again that your Tax Identification Number (TIN) is correct. Yes, you may have already verified it electronically, but numbers sometimes get transposed. Please do it…
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