Roji Intel Blog

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MACRAMerit-Based Incentive Payment System (MIPS)Qualified Clinical Data Registry Reporting
April 5, 2017

Do Centers of Excellence Lose Under New MACRA MIPS Episodic Cost Measures?

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 of Excellence are likely to be higher cost in comparison with other providers, associated episodic cost measures may possibly be used to penalize their providers. The impact won’t be felt immediately, however; in 2017 the MIPS Cost component is scored but not calculated in the…
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Dave Halpert 0
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Alternative Payment Models (APM)Meaningful UseMerit-Based Incentive Payment System (MIPS)PQRS ReportingQualified Clinical Data Registry ReportingValue Modifier
February 28, 2017

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 still a path to 2016 PQRS success, even if you aren’t “PQRS Ready.” More importantly, if you follow these three steps, you’ll also create a pathway to success in the Quality Payment Program (either through MIPS or an APM)—both by avoiding penalties, as well as…
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MACRAMerit-Based Incentive Payment System (MIPS)Qualified Clinical Data Registry ReportingRegistry Science
February 7, 2017

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 is Important to Current and Future Roji Health Intelligence Clients ONC-Health IT Certification provides Roji Health Intelligence with additional capabilities for streamlining performance measurement and improvement. This is especially important for the Roji Health Intelligence Qualified Clinical Data Registry (QCDR), which has unique advantages for…
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Dave Halpert 0
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PQRS ReportingQualified Clinical Data Registry ReportingValue ModifierValue-Based Health CareValue-Based Payment Modifier
November 22, 2016

Improve MAV Audit Success with Expert Data

There are 198 measures available for PQRS Registry Reporting in 2016—seems like there should be enough options to select the most advantageous measures for providers. Unfortunately, however, that’s not the case. Even though there are a whopping 21 measures that could be skipped for each 1 reported, and twice as many National Quality Strategy (NQS) Domains as needed, not everyone will be able to report on 9 measures across 3 Domains (including a cross-cutting measure!). Why is there difficulty in meeting basic reporting requirements? Because measures do not apply to specialties in equal amounts, nor are they evenly distributed within…
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MACRAPerformance ImprovementQualified Clinical Data Registry ReportingValue-Based Health Care
October 25, 2016

Your Wish List for MACRA Performance Improvement Technology

Even as CMS has eased the transition to MACRA with the Final Rule published on October 14, managing under Risk remains a core goal. The best way to prepare your organization? Develop MACRA Improvement Activities (formerly CPIAs), the training ground for managing under Risk. The MACRA Improvement Activities cover all of the processes and root causes of health care cost increases, and Medicare wants you to address them. Hint: they’re scoring your work. While the MACRA requirements are now superficially easy to meet—attest to at least one Performance Improvement Activity—the reality will be very different if you are really preparing for…
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Alternative Payment Models (APM)MACRAPerformance ImprovementValue-Based Health Care
September 20, 2016

MACRA APM Risk: 5 Keys for Redefining Performance Improvement

Whatever relief providers felt after the recent CMS MACRA Pick Your Pace announcement, don’t be fooled. CMS has not, it seems, backed off its goals of pushing providers toward Risk, nor the interim and final quotas for participation. To the contrary—the announcement pointedly suggested that providers consider joining a risk-based Alternative Payment Model (APM) in 2017. But here’s the bigger issue: most existing ACOs have failed to meet cost targets, and the risk of losses for risk-based APMs will fall back on the participating providers. MACRA Pick your Pace should not be a time of rest. You should run, not…
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Future of Health CareMACRAMeaningful UsePerformance ImprovementPQRS ReportingQualified Clinical Data Registry ReportingValue ModifierValue-Based Health Care
September 13, 2016

CMS Okays MACRA Flexibility: Standstill or Startup for Providers?

With the CMS announcement last week that the final MACRA Rules will let providers pick and choose activities—or even delay requirements—2017 implementation is now a toss-up. Will providers double down on efforts to meet the MACRA standards in 2018? Or, will eased deadline pressure reverse momentum within health care systems? There are many valid reasons why the lead-time decision is important. MACRA represents one of the biggest overhauls of the Medicare reimbursement program, and many of the elements have not been fleshed out. Releasing final rules one month in advance of their going into effect surely makes it difficult for…
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Alternative Payment Models (APM)MACRAMerit-Based Incentive Payment System (MIPS)Performance ImprovementQualified Clinical Data Registry ReportingValue-Based Health Care
September 7, 2016

Back to School: Your Post-MACRA Study Guide for QPP Success

Back to school. That phrase prompts memories of making new friends (and catching up with old friends); carts full of notebooks, binders and pens; new classes; and, of course, abject terror. As the summer sun sets on PQRS, the Value Modifier (VM) and Meaningful Use (MU), it’s time for all of us to get into back-to-school mode, take the lessons we’ve learned and build on them for future success. Unfortunately, however, there’s an added challenge. Rather than having a season off to rest, regroup and ease into the new fall schedule, the transition from old programs to new is immediate…
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ACO ReportingAlternative Payment Models (APM)MACRAMerit-Based Incentive Payment System (MIPS)Qualified Clinical Data Registry Reporting
August 23, 2016

ACO Under MACRA? Five Essential Takeaways

While Accountable Care Organizations (ACOs) get a little boost under proposed MACRA Rules, this comes at a price. MACRA provides a 5 percent bonus and a MIPS reporting exemption for providers who participate in an Advanced Alternative Payment Models, the most common being a Stage 2 or 3 ACO—if and only if they assume a minimum requirement for risk. The deal is this: CMS wants providers to move toward Alternative Payment Plans with greater financial risk by living under the equivalent of a budget for their patients’ health care. That concept, which imposes downstream risk to physicians if the budget…
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MACRAMerit-Based Incentive Payment System (MIPS)Performance ImprovementQualified Clinical Data Registry ReportingValue-Based Health Care
August 16, 2016

Can MACRA Help Patient-Centered Medical Homes Succeed?

The concept of a Patient-Centered Medical Home (PCMH) fits neatly into Value-Based Health Care: patients who are well should incur lower costs. And, if primary care providers help patients who are not well to manage chronic diseases and better navigate the system, outcomes and costs should also improve. But those results are not yet proven. Like any new delivery model, the solution can only work if providers have the commitment and tools to realize its potential. This is why MACRA’s new emphasis on the Patient-Centered Medical Home includes many incentives to engage providers. The PCMH features strongly under MACRA. Medicare’s…
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