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 […]
New Year’s Resolution: Know the Difference Between PQRS and Meaningful Use
No one wants another CMS penalty letter this coming year. Especially after the past two weeks, when many providers from coast to coast learned that their Medicare Part B reimbursements in 2015 will be cut by 1.5 percent, since they were eligible but did not participate in PQRS 2013. Caught by surprise, some providers were shocked […]
Season’s Greetings from CMS: You Owe 1.5 Percent for a PQRS Reporting Failure
‘Tis the season to be jolly—unless your health care organization is one of many last week that received a letter from the Centers for Medicare and Medicaid Services (CMS) informing you that at least one of your providers was eligible to participate in PQRS in 2013, but failed to do so—and that a penalty is […]
PQRS 2015: How Your Practice and Patients Can Benefit from New Population Health Measures
Good news for providers who have criticized PQRS as mundane and want to improve assessment of patient outcomes and reduce gaps in care: Medicare’s PQRS 2015 Rule is shifting away from rewarding fragmented quality services and toward population health. With the expansion of the related Value-Based Payment Modifier (VBPM), every group can turn population health […]
Specialists at Risk: How To Navigate Hazards in Medicare’s Value-Based Purchasing Programs
Heads up, specialty providers. The future of your practice may depend on three key components in Medicare’s Value-Based Purchasing program. Especially if you work in an independent practice with a higher proportion of Medicare patients than many primary care physicians, your income and practice survival are at risk if you don’t understand implications of the […]
Final PQRS 2015 Reporting Rule: Higher Penalties and Tougher Requirements
Looking for a good bedtime read? CMS has finalized its 1200-page Medicare Physician Payment System rule for 2015. While the full version is a sure cure for insomnia, buried within are two areas worth your attention: 2015 PQRS Reporting, and Medicare’s Value-Based Payment Modifier (VBPM). Central to Medicare’s value-based health care efforts, both impose stiffer penalty […]
Is Your PQRS Program “Old School”? Shift Your Focus to Competitive Performance in 5 Key Steps
It used to be that CMS rewarded providers almost exclusively on the reporting of PQRS quality measures. Providers received a Medicare bonus even if they did not meet a measure’s performance. Medicare still requires PQRS reporting to avoid penalties and receive a bonus, but CMS has now made it the first step in a larger […]
How to Integrate Strategic Quality Initiatives with PQRS Reporting: The QCDR Opportunity
For 2014 and beyond, CMS has created a new mechanism for PQRS reporting—the Qualified Clinical Data Registry. QCDR reporting requirements are the same as for a traditional Registry utilizing individual measures: A provider must report on at least nine measures. These measures must represent at least three National Quality and Strategy (NQS) Domains. Each of […]
Still Not Sure of Your PQRS 2014 Strategy? Delays Will Cost You
If your organization is just beginning to think about PQRS reporting for 2014, beware. End-of-year data collection is no longer enough to meet PQRS requirements. That’s because PQRS is no longer a quality “reporting” program; it’s now all about performance. In fact, waiting to determine your 2014 PQRS strategy until the last minute is actually […]