After years spent transforming your health care technology, you may feel like you’re almost done. But Value-Based Care Technology requires a different mindset. With reimbursement scaling to a tipping point for APM adoption, think “reboot” instead. Your health system or group has a long way to go if your aggregated and integrated data cannot support […]
How Will New Primary Care Models Affect Providers in VBHC?
Embraced by some provider groups and disparaged by others, CMS’s five new payment models for practices focused on primary care include much to consider. All reflect a key departure of Medicare’s Value-Based Health Care (VBHC) efforts to date: they are direct efforts by Medicare to transition physician practice revenues to risk without the necessity of […]
No More MIPS Cost Score Details? 5 Ways Providers Can Still Take Control of Costs
CMS is urging providers to participate in ACOs with downside risk, but they might be eliminating one of the keys that providers need to prepare. It couldn’t come at a worse time, when providers already stand to lose under risk-based models if they can’t identify where their cost issues lie. That data is only available […]
Tipping Point Test for ACOs: Consent to Financial Risk
Last week the conversation about financial risk for providers in ACOs took on a decidedly different and more contentious tone. After months of CMS reports of ACO growth and success, while retreating on MIPS quality reporting requirements as concessions to “provider burden,” CMS signaled that they were finished waiting for providers to accept financial risk […]
October 2 Is Almost Here: Are You MIPS-Ready?
Calendar check! October 2, the last chance to start your continuous 90-day participation in MIPS, is nearly here. Those who meet minimum standards in the “Pick Your Pace” transition year will avoid a whopping 4 percent penalty on their 2019 Medicare Part B reimbursements. Those who exceed these requirements and perform strongly in MIPS stand […]
Who Will Fill the Leadership Void in Health Care Reform if MACRA Rolls Back?
Amidst the political cacophony over health care coverage for American consumers, a fundamental question has been relegated to a soundbite: How can we control cost? Everyone (in the industry or participating in the debate) knows that cost drives our health care system problems, including affordable insurance coverage. The fallacy at the heart of all the […]
Increase MIPS Versatility and Results with an ONC-Health IT Certified QCDR
Providers focusing on MACRA in 2017 have a menu of choices for implementation—perhaps even too many. But don’t overlook this option for meeting requirements for MIPS (or preparing for an Alternative Payment Model or APM): a Qualified Clinical Data Registry (QCDR). And make sure that your review of the QCDR option focuses on the top […]
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 […]
PQRS Homestretch: Finish Line In Sight (But You Haven’t Crossed It Yet)
It’s almost time to bid farewell to PQRS (formerly PQRI), and say hello to the Merit-based Incentive Payment System (MIPS). But PQRS hasn’t ended yet; even when it does, financial implications will not be felt until 2018. Those who do not report PQRS are at risk of being penalized twice, once for PQRS and once […]
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) […]