Since 2017, the Centers for Medicaid and Medicare Services (CMS) Merit-Based Incentive Payment System (MIPS) has provided eligible clinicians a score of zero -100 annually based on the clinician’s efforts and data collection in four program categories: Quality, Improvement Activities, Promoting Interoperability, and Cost. A clinician’s final score for each year’s MIPS performance ultimately dictates a payment adjustment that is applied to his or her Medicare Part B reimbursement rate two years later. In practical terms, this means that a clinician’s 2017 performance impacts all of his or her Medicare claims that are filed in the 2019 calendar year.
In last week’s blog, Point: The Promise of Blockchain, we discussed some of the exciting features of blockchain technology as it begins to take hold of the healthcare IT field. This week, we’re looking at the other side of the coin by outlining some of the pitfalls related to this technology.
Blockchain. It’s one of the biggest buzzwords in the Health IT industry today—and no wonder, because it seems to be an extremely promising technology, one that we've been keeping our eyes on for a few years now. Still, as cool as it seems, we have a long way to go. That’s why in this pair of blogs, we’re going to look closely first at the possibilities, and then at the hazards, that go hand in hand with this exciting trend.
Look, we understand, we really do. MACRA is frustrating for doctors who want to spend more time talking to patients than checking boxes, and it’s often hard to recognize what, if anything, its requirements are actually doing to move practices toward value-based care. So of course it’s tempting to believe all those rumors (you know, the ones that have been flying around since the law was passed in 2015) about how MACRA and MIPS are on their way out, how CMS will be repealing the law any minute, how maybe it is an option to cover your ears and whistle until it goes away.
But we’ve been paying close attention to the shifting landscape of CMS policy since we released MIPSPRO in 2009, and in our expert opinion, the law isn’t going anywhere any time soon. Here are three reasons why.
CMS recently released the 2017 Quality Payment Program Experience Report, which provides an overview of the clinician reporting experience during the first year of the QPP with the intent of helping clinicians, stakeholders, researchers, and others to better understand the program. The report discusses both MIPS and Advanced APMs during the 2017 performance year, breaking the data down into the following four categories:
“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!
Topics: Industry insights
Value-based care seems like such a good idea. Who doesn’t want better health, and better care, at a lower cost? It is one of the premises of the MACRA legislation: “Change the way that Medicare rewards clinicians for value over volume.” We all think, in theory, preventive care is better than fixing problems after they occur. That’s why we take our cars in for regular maintenance, we have our furnace checked each year before winter, we get our teeth cleaned and checked every six months.
Yet, the current evolution to value-based care is adding burden and distracting from care in many ways, rather than focusing on the intended goals. I attended the Patient-Centered Oncology Care (PCOC) 2018, the annual meeting presented by The American Journal of Managed Care, last week and listened to some of our most highly-trained and most needed oncologists talk about how the current payment models have affected their practices. Oncology practices have been asked to take on risk for the cost of care and manage that cost. These practices are now responsible for costs that are not within their control, and that they don’t even know about until long after decisions have been made.
Topics: Industry insights
Conferences are a reality of business life. Whether this is your first conference or your 10th, it's easy to be overwhelmed by the exciting blend of travel, free meals, sessions, contacts, conversations, and business cards. Truth be told, conferences are a great way to learn from experts in your field and an essential networking opportunity (yes, even for introverts!). As we prepare for the upcoming MGMA Conference, we want to share some tips and tricks for new and experienced conference attendees. From the pre- conference planning to the post- conference follow up, we're here to provide you with 10 tips and tricks to get the most out of your next conference.