The Healthmonix Advisor

A Summary of the 2020 MIPS Proposed Rule

Posted by Christina Zink on July 29, 2019

Today, CMS posted CY 2020 Updates to the Quality Payment Program to the Federal Register. Many clinicians are still trying to wrap their heads around how to report MIPS in 2019, but the release of the 2020 proposed rule is advantageous in deciding what to conquer both this year and in the future. As the title suggests, this document also covers other Quality Payment Program tracks, like Advanced APMs; however, for now we will just focus on the MIPS component of the proposed rule.

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Topics: MACRA & MIPS, Policy

Everything You Need To Know About MIPS Cost in 2019

Posted by Christina Zink on July 18, 2019

The CY 2019 Medicare Physician Fee Schedule Final Rule involves a slew of regulatory changes that will apply to the 2019 performance year. Of course, wading through the final rule to find and understand the most important features of the policy can be grueling; but you’re in luck, because we’ve already done it so you don’t have to! In today’s blog, we’re focusing on the MIPS Cost category.

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Topics: MACRA & MIPS, Policy, Cost Performance Category

Everything You Need To Know About MIPS Improvement Activities In 2019

Posted by Christina Zink on June 6, 2019

The CY 2019 Medicare Physician Fee Schedule Final Rule involves a slew of regulatory changes that will apply to the 2019 performance year. Of course, wading through the final rule to find and understand the most important features of the policy can be grueling; but you’re in luck, because we’ve already done it so you don’t have to! In today’s blog, we’re focusing on the MIPS Improvement Activities (IA) category.

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Topics: MACRA & MIPS, Policy, IA Performance Category

Everything You Need To Know About MIPS Quality in 2019 Part 2: Scoring

Posted by Christina Zink on May 30, 2019

In our last blog we gave an overview of the MIPS Quality Performance Category and discussed its reporting requirements. This week, we'll look more in-depth at how this category will be scored for the 2019 performance year.

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Topics: MACRA & MIPS, Policy, Quality Performance Category

Everything You Need To Know About MIPS PI In 2019

Posted by Christina Zink on May 23, 2019

The CY 2019 Medicare Physician Fee Schedule Final Rule involves a slew of regulatory changes that will apply to the 2019 performance year. Of course, wading through the final rule to find and understand the most important features of the policy can be grueling; but you’re in luck, because we’ve already done it so you don’t have to! In today’s blog, we’re focusing on the MIPS Promoting Interoperability (PI) category.

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Topics: MACRA & MIPS, Policy, PI Performance Category

Everything You Need To Know About MIPS Quality in 2019: Reporting Requirements (1/2)

Posted by Christina Zink on May 23, 2019

The CY 2019 Medicare Physician Fee Schedule Final Rule involves a slew of regulatory changes that will apply to the 2019 performance year. Of course, wading through the final rule to find and understand the most important features of the policy can be grueling; but you’re in luck, because we’ve already done it so you don’t have to! In today’s blog, we’re focusing on the MIPS Quality Performance category.

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Topics: MACRA & MIPS, Policy, Quality Performance Category

CMS To Launch New Payment Models For Value-Based Transformation

Posted by Christina Zink on April 26, 2019

On April 22, the U.S. Department of Health and Human Services (HHS) and Centers for Medicare & Medicaid Services (CMS) announced the CMS Primary Cares Initiative, a new set of payment models that are part of HHS Secretary Alex Azar’s value-based transformation initiative. The CMS Primary Cares Initiative will be administered through the CMS Innovation Center. CMS expects the new programs to shift at least one quarter of people in traditional Medicare out of fee-for-service.

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Topics: CMS, Policy, VBC

Breaking: CMS Measure Change May Affect ACO Shared Savings

Posted by Christina Zink on April 12, 2019

According to a recent announcement from the National Association of ACOs (NAACOs), CMS failed to adequately communicate significant changes to measure ACO-17, Preventive Care and Screening, Tobacco Use- Screening and Cessation Intervention, until after 2018 quality reporting had begun. NAACOs believes that CMS’s failure to communicate these changes will result in unintended consequences such as lowered or even eliminated shared savings rates for ACOs that consequently received a lower performance score or failed to meet quality standards.

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Topics: CMS, ACO, Policy, APMs

Seven Exceptions to the Information Blocking Provision (in the Proposed Rule on Interoperability)

Posted by Christina Zink on March 6, 2019

The U.S. Department of Health and Human Services (HHS) recently proposed a new rule to support the access, exchange, and use of electronic health information (EHI). The proposed rule encourages the adoption of standardized application programming interfaces (APIs), which will help allow individuals to securely and easily access structured EHI using smartphone applications. This facilitates a patient's ability to access their health information by requiring that patients be able to electronically access all of their EHI for free. It also implements the information blocking provisions of the Cures Act.

The rule gives seven exceptions to the definition of information blocking (proposed at 45 CFR 171.201–207). If an actor (a healthcare provider, HIT developer, or HIE or network) satisfies one or more exception, their actions would not be treated as information blocking and they would not be subject to civil penalties and other disincentives under the law. These seven exceptions are outlined below (this information based on the CMS fact sheet found here).

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Topics: Interoperability, Policy

MIPS Final Score Calculation in 2019: What You Need To Know

Posted by Christina Zink on February 20, 2019

The CY 2019 Medicare Physician Fee Schedule Final Rule involves a slew of regulatory changes that will apply to the 2019 performance year. Of course, wading through the final rule to find and understand the most important features of the policy can be grueling; but you’re in luck, because we’ve already done it so you don’t have to! In today’s blog, we’re focusing on how MIPS final scores will be calculated, as well as factors that may lead to reweighting, in 2019.

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Topics: MACRA & MIPS, Policy