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 […]
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 […]
Medicare’s 2016 Proposed Rule: What Do You Need to Know?
Is PQRS dead? That’s the question we’ve been hearing, in the wake of the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA), which outlined a new program for merit-based payments. With the release of the 2016 Proposed Rule, the answer is a resounding “No.” The Proposed Rule is exactly that—proposed, rather than final. Nevertheless, […]
Are Your Specialists and ACO Ready for the Referral Revolution? Part 1
The practice of physician-determined referrals to specialists is deeply embedded in the culture of medicine. But it no longer works under Value-Based Health Care. A revolution in referrals is underway, one that will dramatically change physician alignment and engagement in ACOs and other Pay for Performance models. Outcome measures can distinguish the performance of one specialist […]
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. […]
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 […]
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 […]
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. […]
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 […]
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 […]