Healthmonix Advisor

The end of leniency: Preparing for QPP and MIPS participation in 2024

Posted by Lauren Patrick on March 7, 2024

2024 stands as a pivotal year for healthcare providers, marking the end of leniency granted since the COVID-19 Public Health Emergency began. Participation in the Quality Payment Program (QPP) and the Merit-based Incentive Payment System (MIPS) is no longer optional — if providers fail to engage, they’ll face penalties.  

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Topics: Healthmonix

2024 quality measure selection and scoring: A critical turn for MIPS participants

Posted by Lauren Patrick on February 22, 2024

For the first time since the COVID-19 Public Health Emergency (PHE), all eligible clinicians must engage with the MIPS program or face a stark 9% cut in Medicare Part B claim reimbursements. With the stakes raised this year, scores have become pivotal. Additionally, the threshold for avoiding penalties has jumped in recent years, making high scores a coveted achievement. 

Within MIPS, the quality component demands each clinician or group to report on 6 quality measures. The scoring landscape, however, has shifted: 

  • Bonus points for eCQM and additional high-priority measures have been eliminated. 
  • The baseline score for measures has been reduced from 3 points to 0 for non-small practices, adding to the competitive tension. 
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Topics: Healthmonix

Elevating healthcare excellence: Healthmonix achieves HITRUST certification

Posted by Lauren Patrick on February 6, 2024

In the dynamic landscape of healthcare technology, data security and compliance are paramount. As we witness the rapid evolution of digital health solutions, patients and healthcare providers alike demand robust safeguards to ensure the confidentiality, integrity, and availability of sensitive information.

We're thrilled to announce that Healthmonix, a leading value-base care organization in healthcare technology, has achieved the prestigious HITRUST certification, reinforcing our commitment to excellence in data security. 

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Topics: Healthmonix

Healthmonix's journey to a new look and expanded focus on value-based care

Posted by Savannah Vasquez on December 7, 2023

Were thrilled to offer you a sneak peek atHealthmonixs upcoming rebrand,which will launch this month. Get ready to bid farewell to our current look and embrace the new Healthmonixas we embark on a transformative journey. 

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Topics: Healthmonix

Further thoughts on the 2024 Final Rule and the Quality Payment Program

Posted by Lauren Patrick on November 16, 2023

Background: Under the Quality Payment Program (QPP), eligible clinicians face payment adjustments determined by their performance in the Merit-Based Incentive Payment System (MIPS) or choose to participate in the Advanced Alternative Payment Model (APM) track. Those in MIPS see their payments increased, maintained, or decreased based on relative performance in four categories: Quality, Cost, Promoting Interoperability, and Improvement Activities.  

Clinicians participating in an Advanced APM are exempt from MIPS and were initially qualified for a 5% bonus payment. However, after the expiration of the 5% bonus, Congress reauthorized the bonus at a reduced rate of 3.5% for the year 2023. Additionally, the Centers for Medicare & Medicaid Services (CMS) has introduced a new alternative to traditional MIPS known as the MIPS Value Pathways (MVPs), which is a voluntary option for eligible clinicians.

The program continues to evolve at a macro level, as CMS has a vision to move providers out of ‘traditional MIPS’ and into other reporting options such as APP for Shared Savings participants, MVPs for those still in fee for service, and APMs for other provider programs. In addition, CMS continues to pursue the Universal Foundation. Providers need to be prepared for bigger shifts in their quality reporting strategies as CMS aligns programs under the National Quality Strategy.

Below we explore some of the key takeaways from the 2024 PFS Final Rule impacting the QPP program.

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Topics: Quality Performance Category, MIPS Reporting

7 initial takeaways from the 2024 PFS Final Rule

Posted by Lauren Patrick on November 3, 2023

In the 2024 Medicare Physician Fee Schedule (PFS) Final Rule released yesterday, CMS is emphasizing getting the Quality Payment Program (QPP) “back on track with the trajectory we had planned before the public health emergency (PHE)”. They’re focused on ensuring that the program resumes its intended progress, which was interrupted during the PHE over the last few years. 

Here's an initial breakdown of what this means. 

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Topics: Quality Performance Category, MIPS Reporting

Medicare Shared Savings Program announces savings and quality results for 2022

Posted by Lauren Patrick on October 13, 2023

Quality scores matter! 

The Medicare Shared Savings Program (MSSP) saved $1.8 billion for Medicare in 2022, according to last month’s announcement by the Centers for Medicare & Medicaid Services.1 This marks the second-highest yearly savings since the program’s start. It further underscores the program’s track record of consistently generating savings and delivering high-quality performance for the sixth consecutive year, as noted by CMS. 

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Topics: ACO, MIPS Reporting

Overcoming Challenges in Patient Matching and Deduplication  for ACO Quality Reporting

Posted by Lauren Patrick on September 28, 2023

ACOs have encountered challenges with aggregating, matching, and deduplicating extensive, disparate patient data required under the eCQM and MIPS CQM quality measure collection types. Patient matching and deduplication are needed to accurately calculate quality metrics from data across multiple practices and EHR instances.  

Read on as we unravel the challenges and several methods to overcome these challenges. 

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Topics: MACRA & MIPS, MIPS CQMs, MIPS Reporting

The MIPS Cost category’s impact on orthopedic groups

Posted by Lauren Patrick on September 14, 2023

In the ever-evolving healthcare world, staying current is vital. Orthopedic surgery, particularly arthroplasty, has been at the forefront of the shift toward value-based care models. With certain procedures already subject to bundled payments for over a decade, the integration of cost measures within the Merit-Based Incentive Payment System (MIPS) is a game-changer.

Read on as we unravel the vital details of this essential aspect of modern healthcare performance assessment.

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Topics: MACRA & MIPS, MIPS CQMs, MIPS Reporting

Hospitals are seeing the impact of the MIPS Cost Category for 2024 reimbursements.

Posted by Lauren Patrick on September 7, 2023

With 2022 MIPS final scores available, hospitals and health systems have seen the Cost category produce a major impact on their overall MIPS scores.  

Before CMS added the Cost category to 2022 MIPS scores, hospitals had little insight into how it would impact MIPS scores. With scores out, we see that many hospitals and health systems were scored on over 10 Cost category measures. That’s a large amount of data to sift through and analyze.

 

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Topics: MACRA & MIPS, MIPS CQMs, MIPS Reporting