The Healthmonix Advisor

HIMSS 2017 Orlando – The Happiest Place on Earth?

Posted by Lauren Patrick on March 2, 2017



HIMSS is the seminal event in healthcare technology each year.  This year it grew to 45,000 attendees and literally a mile of exhibit hall.  We logged miles of walking in one day just to cover the exhibit floor, and still did not see it all.  At this pivotal time in healthcare information technology, there were many important themes that were covered.

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Topics: PQRS

The future of MACRA with Tom Price as the Secretary of HHS

Posted by Lauren Patrick on February 16, 2017

Early on the morning of February 10th, the Senate approved the nomination of now-former Rep. Tom Price to be the Secretary of Health and Human Services.  While some say his chief priority is “dismantling of the Affordable Care Act”  (Sen. Maria Cantwell of Washington), the tasks that will be put in front of him also include five major health IT initiatives:  appointments to ONC and other agencies, the future of MACRA and Meaningful Use, the enforcement of interoperability, telemedicine, and cybersecurity. 

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Topics: PQRS

CMS ICD-10 Addendum - You still have to report PQRS!

Posted by Lauren Patrick on January 26, 2017

In December we posted about a CMS announcement related to ICD-10 diagnosis and procedure code changes, and how this might affect payment adjustments in 2018. At the time CMS had not yet issued their addendum detailing specific code updates for measures being used in the Merit-Based Incentive Payment System (MIPS), but now that they have, here’s an update:

CMS and the National Library of Medicine (NLM) have published the addendum to the 2016 eCQM specifications which affects ICD-10 Clinical Modification (CM) and Procedure Coding System (PCS) value sets for 2017. Health Quality Measure Format (HQMF) specifications, value set object identifiers (OIDs), and measure version numbers for 2017 were not changed. The eCQM value set addendum for 2017 is published to the
eCQM Library and the eCQI Resource Center. The NLM’s Value Set Authority Center also provides a complete list of revisions to the eCQM value sets.

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Topics: PQRS

Video: Understanding PQRS Eligible Instances

Posted by Christina Zink on December 30, 2016

When reporting individual quality measures, whether it be for PQRS this year, or for one of the performance categories of MIPS next year, you are expected to report at least 50% of your eligible instances for each measure. In our experience, this concept can be confusing when practically applied. Luckily, it can be disambigusted in five easy steps!

 

 Consider All Patient Visits for the Performance Period

A performance period for PQRS is based on a complete calendar year beginning on January 1 and ending on December 31. 

For MIPS reporting, the performance period can range from a continuous 90-day period to the full calendar year.

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Topics: PQRS

Yes, You Still Have to Report PQRS in 2016!

Posted by Christina Zink on December 16, 2016

Last night, a very surprising article was promoted, "CMS waves Physician Quality Reporting System penalties for 2017, 2018 after massive ICD-10 update clogs system." This post makes it seem as if only the Value-Based Modifier (VM) program penalties and incentives would still be in effect based on PQRS reporting done in 2015 and 2016. This is a dangerous misconception.

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Topics: PQRS

Getting Started with PQRS Measure Selection

Posted by Christina Zink on December 9, 2016

Once you've selected how you will report, the next step is to determine what you will report. This is called your reporting method. You have two options: reporting a measures group or reporting individual measures. 

Last week, we discussed the first step to reporting PQRS in 2016, selecting a submission mechanism. To briefly recap, there are three submission mechanisms that are viable for practices starting to report at this point in the year: Registry, EHR, and QCDR. Of these three options, Registry reporting has the highest rate of success and ease of submission. 

Download Your Free PQRS 2016 Guide Now!

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Topics: PQRS

PQRS Feedback Reports

Posted by Seretha Curry on December 2, 2016

We call it “Informal Review Season”.  You could also call it “the Nightmare Vaguely Before Christmas” for
 providers who bill Medicare Part B services.  The 2015 PQRS Informal Review season (this year September 26
th through November 30th) is that most wonderful time of the year when practitioners and practice administrators nervously await the release of feedback reports in September.  Instead of children wondering whether or not they’ve made Santa’s list, you’ve got providers and practitioners feverishly paging through their QRURs to see exactly how naughty or nice they are, according to CMS.  (Note: Documents released in the fall of 2016 pertain to the 2015 PQRS or VBM reporting period).

 

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Topics: PQRS

2016 PQRS Reporting Made Simple

Posted by Christina Zink on December 1, 2016

Reporting PQRS in 2016 is just as important as ever, with up to 6% of your Medicare Part B reimbursements on the line in 2018. According to the latest PQRS experience report[1], about 66% of eligible providers are participating in PQRS. Of these participating providers, 68% are still reporting using the claims-based reporting mechanism, which has an abysmal 40% success rate in avoiding the PQRS penalty. Just taking these numbers into account, this takes us up to at least 61% of PQRS eligible providers not avoiding the PQRS penalty.

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Topics: PQRS