Halloween may be over, but CMS has given us one more scare—a 1,653-page Final Rule for Year 2 of the Quality Payment Program. The Proposed Rule represents the next phase of the transition into a full-fledged Quality Payment Program. For eligible providers, more is required to avoid penalties, but CMS has defined the process to […]
Can Value-Based Health Care Help Consumers Choose Doctors? 12 Questions to Ask
Do consumers and other health care purchasers have the ability to choose providers based on quality and cost? That’s the assumption beneath attempts by Medicare and health plans to reimburse providers based on their ability to deliver better quality while constraining costs. Value-Based Health Care also includes programs by commercial insurance to offer “narrow” provider […]
Turning Patients into Health Care Consumers—For Economic Survival
If we want to help people take better charge of their health—both physically and financially—we should start by treating them as real consumers, instead of patients. While that may seem like a simple change in terminology, it is anything but. A Patient Is a Recipient of Services, Not the Actor Health care organizations often work […]
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 […]
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 […]
Putting the “Meaning” in MU Public Health Reporting: How to Move Beyond “Check the Box”
Can Medicare influence health care delivery via the “public health” reporting requirements of the EHR Incentive Program? That question is central to the updated EHR Incentive Program (more commonly known as Meaningful Use, or “MU”). The answer boils down to a fundamental choice: whether providers view the external reporting Objective as just one more compliance […]
Will Medicare’s Published Physician Quality Data Push Your Patients Away?
CMS isn’t the only group scrutinizing your quality and cost data any more. As the next step toward value-based health care, Medicare has begun publishing provider performance data for PQRS under “Physician Compare.” Now patients and their families can make their own data-driven choices about health care providers with an online search. The website is a game-changer. […]
Medicare Is Playing by 2015 Rules—Are You?
Does it feel like 2015 yet? While we may fill out paperwork that reads “2014 2015” for the next few weeks, 2015 is here—and it’s different. Do you need evidence? The 2015 Medicare Physician Fee Schedule is officially in effect. Several hundred pages within the 1200-page “Final Rule” describe the rules for the 2015 Physician Quality […]