Roji Intel Blog

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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Theresa Hush 0
0
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
0
AttributionPQRS ReportingValue-Based Payment Modifier
August 25, 2015

How to Boost Your VBPM with ICD-10

With five weeks until ICD-10 becomes official, take note: Your transition strategy must include PQRS and the Value-Based Payment Modifier (VBPM). Neglecting VBPM in your short-term plan may lead to long-term penalties. That now goes for everybody, whether you helm an Academic Medical Center or run a small practice. October 1, 2015, marks the starting date of the new coding set for diagnoses and inpatient procedures. ICD-10’s increased specificity dovetails with how medicine is practiced today, versus the 36-year-old ICD-9 coding. Given a choice between implementation and lost revenues, practices will have no option but to make the transition. As…
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Dave Halpert 0
0
ACO ReportingPQRS ReportingQualified Clinical Data Registry ReportingValue-Based Payment Modifier
August 18, 2015

Radiologists’ Tool Kit: How to Succeed in PQRS and VBPM

When it comes to PQRS reporting, it’s not easy being a radiologist. How can you fulfill PQRS reporting requirements and avoid jeopardizing future value-based payments? Many radiologists have found themselves backed into a PQRS corner—not enough measures to report, and those measures that can be reported have some tricky requirements. Similar to anesthesiologists, radiologists practice in a variety of settings and perform different types of procedures, according to sub-specialty. Depending on the procedures you perform, the vast majority of PQRS measures may not be applicable to you—not only are they clinically irrelevant, but you couldn’t report them even if you…
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Theresa Hush 0
0
ACO ReportingPQRS ReportingQualified Clinical Data Registry ReportingValue-Based Payment Modifier
July 14, 2015

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. Performance variation between providers is startling. There are 50 provider groups with performance at or lower than 65 percent for at least one published measure. By contrast, a handful of groups show all four measures over 95 percent. The 2013 data are limited and do…
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Dave Halpert 0
0
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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Dave Halpert 0
0
ACO ReportingPQRS ReportingQualified Clinical Data Registry ReportingValue-Based Payment Modifier
June 30, 2015

Orthopedists’ Survival Kit: How to Succeed with Medicare PQRS and VBPM

Pay for Performance success takes careful thought and management, particularly for specialty practices. Under Medicare’s PQRS and Value-Based Payment Modifier (VBPM), specialties have fewer measures available, which narrows reporting options—making it harder for you to meet PQRS and compare well against your peers. For Orthopedics, this is especially true. Nearly 200 PQRS measures have a Registry reporting option, but many orthopedic surgeons still have a difficult time finding nine measures across three National Quality Strategy (NQS) Domains (including one cross-cutting measure), where performance is good enough to report. All too often, orthopedic surgeons get trapped, reporting on measures where performance…
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Theresa Hush 0
0
PQRS ReportingQualified Clinical Data Registry ReportingValue-Based Payment Modifier
June 9, 2015

Does Your EMR Tell Medicare the Right Story About Your Patient Quality?

Reporting physician quality to Medicare through an EMR is an easy and affordable approach—at least on the surface. But be careful when using EHR Direct Reporting for PQRS 2015, so you don’t cost your organization as much as 4 percent in Medicare penalties or create an unappealing profile of your quality in Medicare’s public reporting. Navigating successfully through the maze of Medicare’s new Value-Based Purchasing requires a thorough understanding of how all the different reporting and performance programs interact. Unless you have a good grasp of how your EMR reports your quality data, you risk setting yourself up for costly…
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Dave Halpert 0
0
PQRS ReportingQualified Clinical Data Registry ReportingValue-Based Payment Modifier
June 2, 2015

GPRO Registration Ends June 30—Don’t Lose Your PQRS Reporting Advantage!

The clock is winding down—have you registered your practice for the Group Practice Reporting Option (GPRO) for PQRS?  To report as one collective unit, you must register with Medicare by June 30. If you don’t complete this step, you’ll still have to participate in PQRS, but your group’s providers will need to report on a person-by-person basis, which can be an administrative nightmare and make it much more challenging to succeed under the Value-Based Payment Modifier (VBPM). Tick-tock! GPRO registration is only the first administrative step. There’s a lot more to know in order to avoid penalties, either from failure…
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Dave Halpert 0
0
AttributionPQRS ReportingValue-Based Payment Modifier
May 26, 2015

Provider Network Growth? How to Avoid Unanticipated Medicare VBPM Penalties

Mergers and acquisitions, joint ventures and affiliations—this is the new face of health care, and the trend shows no signs of slackening. If your group has grown and changed significantly through consolidation, you’d best take a second look at your 2013 Quality and Resource Use Report (QRUR). Chances are, it no longer applies to your organization, putting your at risk for significant penalties under the Value-Based Payment Modifier (VBPM). The good news is that CMS has released its Mid-Year 2014 QRURs to all providers, regardless of how many providers are billed under your group’s Tax Identification Number (TIN). Why bother…
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