Are you caught in a squeeze between avoiding penalties in both PQRS and the Value-Based Payment Modifier (VBPM)? Medicare’s move to Pay for Performance has created a Catch-22 for many groups: you may have enough data to report enough PQRS measures, but if you choose to report measures where your performance is below the CMS […]
Your VBPM Incentive Payment Could Be Higher Than You Expect—If You Act Now
Here’s a lesson in budget neutrality, Medicare style: If you are penalized under PQRS for non-reporting or under the Value-Based Payment Modifier (VBPM) for poor performance, your money will be paid out to providers earning a VBPM incentive. That’s right—to your competition. If you’re on the losing end of this equation, you could lose up […]
How to Organize Your Academic Medical Center for PQRS 2015 Success
Take a deep breath. The last-minute flurry of adjustments and updates to last year’s PQRS reporting is over. And—brace yourselves. It’s time to dig into PQRS 2015, which, if you’ve been following our posts, requires a whole new level of rigor to avoid penalties under Pay for Performance. (Download our free eBook, Insider’s Guide to […]
Academic Medical Centers at Risk: How to Survive Medicare and Medicaid Value-Based Health Care
Academic Medical Centers (AMCs) provide care to the most complicated patients and have surmounted some of the worst clinical challenges of all time. Yet the biggest issue to threaten survival of AMCs might well be Medicare and Medicaid Value-Based Purchasing. While AMCs incorporate the training of new physicians in both community and highly specialized care, […]
ACO v Group Practice P4P: How Medicare Costs and Quality Calculations Affect Your Bottom Line
Now that Value-Based Health Care defines the landscape, reporting for revenue is on its way out. Value-based quality is in. Medicare’s transition to Pay for Performance gives providers just three options—and no out—for participating in reimbursement models that reward for higher quality and lower cost: Build or participate in an Accountable Care Organization; Report PQRS […]
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 […]
Tales from the PQRS Trenches: How to Avoid Harm to Your Practice and Patients
With less than three weeks until the final deadline of PQRS Registry Reporting for 2014 services, many providers are still scrambling to figure out their reporting strategy. They will have few—if any—options for success. It’s 2015, the requirements for PQRS reporting are entering their seventh year, and non-reporting penalties have been applied for two years. […]
PQRS 2015 Reporting: How to Go Beyond Basics to Improve Outcomes
Chances are you don’t have time to read through all 1,200 pages of Medicare’s Final Reporting Rule. But if you don’t understand how CMS is moving the Medicare program, and the health care system at large, toward rewarding providers for quality rather than quantity of care, your organization is in for a rude awakening. In […]
Navigating the ACO Labyrinth to Success: How to Find Your Way to Quality and Shared Savings
Last year, less than one quarter of Medicare MSSP ACOs achieved success in generating shared savings. Not a good report card, given that Accountable Care Organizations form for the explicit purpose of delivering high quality, coordinated care, with shared savings as in incentive to avoid duplication of services. But ACOs are complex endeavors, both administratively […]
PQRS Catch-22 for Specialists: How Medicare’s Division of Measures Can Put You at Risk for Penalties
If you are a specialist, maintaining your Medicare revenues just became more challenging. As of 2015, CMS now requires nine measures instead of three for PQRS reporting. They provided a partial reprieve by reducing the completion rate from 80 percent to only 50 percent. However, successful PQRS reporting is all or nothing—failure to report all […]