If you’ve written off population health initiatives as too expensive, think again. Pay for Performance means just what it says: you need to demonstrate better outcomes than your peers if you expect to reap benefits from Medicare. And, if you fall behind, you’ll risk ACO losses or Value-Based Payment Modifier (VBPM) penalties. As we discussed […]
How to Get Paid for Your Population Health Program: Part 1
How can you succeed in Pay for Performance if you can’t risk revenues on a program that may not produce results? Especially if your competitors have made the investment and can prove better outcomes, raising the bar for everyone? It’s not enough simply to tighten existing procedures or to focus on maintaining high standards To […]
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 […]
Who Else Cares for Your Patients? How the Wrong Patient Attribution Can Skew Your VBPM
So, exactly who are your patients? Sounds like a silly question. But when it comes to Medicare’s patient attribution methodology, the answer is not obvious. Medicare attributes patients to providers and practices in order to calculate components of the Value-Based Payment Modifier (VBPM). Like it or not, certain patients can be attributed to your practice, […]
Better Hypertension and Diabetes Outcomes: From Basic Measurement to a Plan for Improvement
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, […]