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 […]
CMS Eliminates Episode Groups in MIPS Cost Tracking for 2018—But Providers Should Not
It’s no surprise that Cost is one of the most significant targets of Medicare Value-Based Health Care initiatives, as well as those in the private sector. So it was a real surprise last month to learn that CMS would delay weighing Cost as a component of MACRA MIPS total scoring. Equally significant is the CMS […]
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 […]
The Future of MACRA: Will MIPS Survive?
Will MIPS survive as Medicare’s overarching performance measurement and improvement program for physicians? That’s the question as providers finalize their plans for meeting requirements in 2017 and beyond. MIPS Is in Adjustment Mode MIPS is undergoing a significant transition. How do we know? First, the ink is hardly dry on the huge rewrite of various […]
Who Will Fill the Leadership Void in Health Care Reform if MACRA Rolls Back?
Amidst the political cacophony over health care coverage for American consumers, a fundamental question has been relegated to a soundbite: How can we control cost? Everyone (in the industry or participating in the debate) knows that cost drives our health care system problems, including affordable insurance coverage. The fallacy at the heart of all the […]
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 […]
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” […]
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 […]
Why MACRA MIPS Cost Episodes Make Good Products for Health Care Consumers
Here’s a radical idea: What if providers re-envisioned MIPS as a patient marketing initiative, not a regulatory response? Yes, I’m serious. From the beginning of PQRS and Meaningful Use to MACRA, health systems considered these efforts to be merely “compliance” with regulations and not market initiatives. But this view is shortsighted. As outlined in MACRA […]
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 […]