The Healthmonix Advisor

Meet Dr. Anand Shah, The New CMS Senior Medical Advisor for Innovation

Posted by Christina Zink on January 31, 2019

In a recent announcement, CMS Administrator Seema Verma named Dr. Anand Shah, a radiation oncologist at the National Cancer Institute, as the new Senior Medical Advisor for Innovation at CMS.

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Your One-Stop Guide To Understanding QP and Partial QP Determinations in 2019

Posted by Christina Zink on January 25, 2019

When the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) was signed into law, it created two distinct pathways for reporting: the Merit-Based Incentive Payment System (MIPS), and the Advanced Alternative Payment Model (Advanced APM). Under MIPS, Medicare Part B payments are tied directly to clinician performance based on Composite Performance Scores (CPS), whereas the Advanced APM track encourages groups of clinicians to take on greater risk (and reward) for cost and quality of care.

In this week’s blog, we’re taking a deep dive into Qualifying APM Participant (QP) and Partial QP Determinations, as laid out in the 2019 QPP final rule.

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Have You Heard Of Patient Relationship Codes? They May Soon Impact Your Bottom Line.

Posted by Lauren Patrick on January 18, 2019

A recent perspective article in the New England Journal of Medicine begins with a bold claim: that patient relationship categories and billing-code modifiers, which clinicians have been able to voluntarily submit since January 1, 2018, “may be one of the least known but most important provisions of the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA).” In today’s blog we’ll explore how patient relationship codes may, as the article predicts, end up impacting reimbursement.

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Disillusioned About MIPS Incentives? Here’s Why You Shouldn’t Be.

Posted by Christina Zink on January 11, 2019

If your organization invested significant money and time into achieving a high MIPS score in 2017, the final incentive payment you received may have felt… well, disappointing. As easy as it may be to recognize the ideological importance of shifting from fee-for-service to value-based care, many clinicians and organizations feel unable to practically justify such an investment in the absence of a meaningful financial incentive.

But there’s good news: incentives will continue to rise in coming years, and those achieving the highest scores will soon find their efforts rewarded on a much larger scale. Here’s why.

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Topics: MACRA, MIPS, QPP

Everything You Need To Know About MIPS Facility-Based Quality and Cost Performance Categories

Posted by Lauren Patrick on January 4, 2019

As laid out in the 2019 MACRA final rule*, one of the ways CMS hopes to expand participation options in the program’s third year is by offering certain facility-based clinicians, if they participate as a group, the option to use facility-based Quality and Cost performance measures. CMS expects to release a facility-based scoring preview for this option, which does not require any data submission, in Q1 of 2019. In today’s blog, we’ll take an in-depth look at the details of facility-based scoring and how it will be applied.

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The Talk of 2019: Data Analytics and Interoperability

Posted by Christina Zink on December 27, 2018

With the new year comes a renewed focus on data analytics and interoperability.

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Three Steps Organizations Can Take to Foster a Patient-Centric Experience

Posted by Christina Zink on December 21, 2018

Patients want to be treated with dignity and respect. And when they are, as the American College of Physicians (ACP) points out in a recent position paper on patient engagement, they are more likely to interpret their experience as a quality care encounter. Organizations can improve outcomes and adherence to care plans by helping patients and families feel central to their own care experience, and research even suggests that patient experience is a more important factor in patient loyalty than standard marketing efforts.

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To Do: Check Your MIPS Eligibility Status, Preview Your QPP Data.

Posted by Christina Zink on December 14, 2018
 

Have you checked your 2018 MIPS eligibility status? Since September?

CMS emailed physicians to let them know that their MIPS status for this year may have changed that recently--and some physicians may find that they are no longer eligible to participate. Although CMS conducted an initial review of Medicare Part B claims and Provider Enrollment, Chain, and Ownership System (PECOS) data between September 2016 and August 2017, further updates were made after a second review that took place between September 2017 and August 2018. If you are eligible, your 2018 performance will affect your 2020 Medicare payment adjustment.

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2018 MIPS Hacking: Avoiding the Penalty as a Small Practice

Posted by Christina Zink on December 6, 2018

Most post offices in the United States stay open late on April 15. The online voter registration portal for voters wishing to weigh in on Brexit crashed due to traffic two hours before the deadline. Our MIPS reporting customer support channels reach their peak traffic between on March 24, a week before the submission deadline. It is clearly human nature to procrastinate, so if you've reached December without a MIPS reporting plan, you're certainly not alone.

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Topics: MIPS Hacking

Chance Breakfast Dr. Barbara McAneny, President of the AMA

Posted by Mike Lewis on November 29, 2018

The early bird gets the worm.” 

I'm not sure when I heard this for the first time, but it became the guiding principle to my work ethic. Always show up first to any event whether personal or professional - that's the code.  This time it paid off!

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