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 […]
Why Bundled Payments Are a Win-Win for Specialists and Health Care Consumers
Bundled payments, a health care payment innovation that has been widely praised for controlling costs, recently got a bad rap. Secretary of Health and Human Services Tom Price has delayed implementation of the final Medicare rule for several bundled payment programs that were set to start this year. He has criticized the bundled payments initiative […]
How to Turn 2016 PQRS Success into Better Care (and a MIPS Win)
March has arrived. The submission window for PQRS shuts on March 31. It’s the moment of truth for providers, practices and Registries. Are you ready to report, ready to panic or somewhere in-between? It’s probably too late to implement an initiative designed to improve your PQRS measures, but with the right Registry partner, there is […]
Roji Health Intelligence’s Roji Registry Earns ONC-Health IT Certification from Drummond Group LLC
Roji Health Intelligence has reached another milestone, enhancing Solutions to help providers achieve better outcomes and lower costs. Roji Registry has earned Office of the National Coordinator for Health Information Technology (ONC-Health IT) 2015 Edition Health IT Module Certification via Drummond Group LLC, an Authorized Certification Body (ACB). See details here. Why ONC-Health IT Certification […]
Can Health Care Stay the Course of Reform Amidst Uncertainty?
With the new year finally here, health care organizations need to know: How should you proceed amidst uncertainty about Medicare policy, including Value-Based and Risk programs initiated by the Obama administration? In the crosshairs are the new, complex Quality Payment Programs under MACRA, including both MIPS and Alternative Payment Models (APMs) such as ACOs. Although […]
New Year’s Prediction: More Cost Sharing for Patients Means Problems for Providers
A year ago we reported on the trend in shifting health care costs to the consumer through higher deductibles, copayments and premium sharing. Fast forward to 2017: expect to see “financial accountability” for patients vastly increase, as health care costs continue their relentless rise and the public policies that support premium subsidies, Obamacare, Medicare and Medicaid […]
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 […]
The MACRA Final Rule: On Your Mark, Get Set . . . Transition!
The Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) has (among other things) repealed the Sustainable Growth Rate and incorporated quality measurement into payment, steering away from traditional Fee for Service payments. In other words, revenues are being tied to quality, rather than volume. The Quality Payment Program (QPP) defined within MACRA offers two […]
Don’t Be Fooled: MACRA Final Rule Still Favors Quality Improvement Leaders
In case you haven’t yet had a chance to digest all 2,400 pages of the MACRA Final Rule, announced by CMS on October 14, here’s the main takeaway: Phasing in the implementation process, CMS has made it much easier to avoid penalties, at least in the short run. But those who push the boundaries of […]
Improve Your Risk Readiness With Physician-Driven MACRA CPIA Innovation
CMS is pushing providers to accept Risk under Alternative Payment Models (APMs), and they’re sweetening the pot with incentives. But for the vast number of providers who will participate in MIPS because they don’t participate in risk-based APMs, the path to reward is murky. That’s because many Health Systems have a hard time visualizing how […]