The shift from volume to value-based care can be frustrating, especially when the reasons behind such a significant change aren’t clear. But with an estimated 250,000 American deaths per year caused by medical errors, minimizing these errors is a noble and vital effort. Additionally, CMS is now raising the bar for healthcare providers with the assessment of quality metrics against benchmarks and peers. With that in mind, let’s break down the meaning of, and intentions behind, Quality Measures.
When we asked MIPS eligible clinicians about their experiences transitioning from PQRS this year, one of the biggest takeaways was that quality matters even more under MIPS than it did under PQRS. Clinicians who want to maximize their reimbursement would consequently be very smart to start reporting as early as possible, and to adjust performance to maximize quality, rather than waiting until the end of the year. If you’re not sure whether or not you are a MIPS-eligible clinician, take advantage of one of the following resources for determining your MIPS participation status as soon as possible so that you don’t get left behind.
We are now in the seventh month of the new Merit-Based Incentive Payment System (MIPS), and the majority of MIPS-eligible clinicians still feel completely unprepared for success. With complicated and changing regulations, ensuring compliance can be a long and arduous process. Like most sizable goals, MIPS is best digested in small pieces, but it is hard to tell where to start sometimes. That is why we are going give you an order of operations to follow to ensure MIPS survival.
Transparency is a vital aspect of the transition to quality care because it allows patients to make more informed healthcare choices. To this end, CMS has increased accessibility of physician information with the Physician Compare website, which publicly reports provider data including some quality measures. If you are a provider and want to assess or even optimize how you appear compared to your peers, you may have questions about how the Physician Compare website works and how to make sure it represents you accurately.
Compared to the commotion surrounding other Trump administration nominees, Seema Verma's confirmation hearing passed by last Thursday with relatively little controversy. Despite the low level of coverage, understanding the contents of this hearing is imperative for predicting the next few years in American health care. As the Administrator for the Centers for Medicare and Medicaid Services (CMS), Seema Verma will shape the future of health care for 34% of Americans. 
With the introduction of MIPS reporting in 2017, and the launch of MIPSPRO, now is the time to be considering efficient ways of fulfilling MIPS requirements. CMS is conducting a study with the aim of better understanding practice's experiences quality reporting that will satisfy the Improvement Activities Performance Category of the Merit-Based Incentive Payment System (MIPS). Applications for this study are going to be accepted from January 1 - 31, 2017.
As I sit in my office, I hear the Christmas decorations coming down. There is comfort in the known passing of the seasons and excitement at Healthmonix as we move into MIPS for 2017. Our new platform for MIPS is ready for launch. We are excited to see our efforts pay off for healthcare.
While the national election means that the Affordable Care Act will likely be changed, MACRA was passed with wide bipartisan support so will likely be staying in place. We at Healthmonix don’t believe the change in administration will affect the underlying efforts to transition to value-based care, either for MIPS or any other initiatives that we currently support. The triple aim (better care, lower cost, better patient experience) is still at the heart of what we do.
Thanksgiving is almost here! For me, this means reflecting on the things in my life that I am thankful for. Along with the tasty food I am about to consume with my loved ones, this year I am grateful for the MACRA Quality Payment Program. This may sound perplexing to you, as the MACRA Quality Payment Program has been causing a lot of alarm in the healthcare industry since the Notice of Proposed Rule Making (NPRM). However, with the release of the final rule came many provisions that I believe will improve the ease of reporting for clinicians while continuing to improve the quality of care for patients.
To briefly refresh before jumping in, the MACRA Quality Payment Program is split into two paths: the Merit-Based Incentive Payment System (MIPS) and Advanced Alternative Payment Models (Advanced APMs). MIPS streamlines pre-existing CMS quality initiatives (like PQRS and Meaningful Use), while Advanced APMs are designed to encourage innovative value-based payment models.
On October 14, 2016, the Department of Health and Human Services release the MACRA Quality Payment Program Final Rule. According to the Executive Summary of the Final Rule, the aims of the Quality Payment Program are to : "(1) support care improvement by focusing on better outcomes for patients, decreased provider burden, and preservation of independent clinical practice; (2) promote adoption of Alternative Payment Models that align incentives across healthcare stakeholders; and (3) advance existing efforts of Delivery System Reform, including ensuring a smooth transition to a new system that promotes high-quality, efficient care through unification of CMS legacy programs."
Recently, we highlighted one of the fastest growing types of initiatives for improving the delivery of value-based care--the bundled payment model--and offered some popular opinions about why it is taking off. This week we’ll dive into some specific bundled payment initiatives past and present.