Since the latest Physician Fee Schedule and Quality Payment Program final rule was released in November 2018, organizations across the country have scrambled to understand key changes that have been made and adapt to their implications. In today’s blog, I want to focus on one change that may well prove significant to billing and Revenue Cycle Management teams: groups of 16 or more can no longer report via claims.

Topics: PRO Tips, MACRA & MIPS, Policy, RCM

As MACRA barrels into its second full year of implementation, we’re noticing mixed reactions to the reporting process. Some practices and organizations have thrown their best efforts into reporting and earning an incentive, while others are only interested in finding the easiest way to get compliant and avoid any penalty on their Medicare Part B reimbursements.

Topics: PRO Tips, MACRA & MIPS, RCM, VBC

By 2018, the Department of Health and Human Services plans to have 90% of the Medicare FFS reimbursements involved in a value-based program.¹ By 2020, a task force including private insurance giants like Aetna and Health Care Service Corporation (HCSC) has committed to converting 75% of their business to value-based incentive programs.² Clearly, there is a demonstrable trend emerging that will be expensive to ignore.The leading program to pay attention to in this major industry shift towards value-based care is the Medicare and Chip Reauthorization Act (MACRA). This post is the first in a series focused on providing you with industry insights and updates that will help prepare you for MACRA and seize incentives now and in the future.

Topics: PRO Tips, MACRA & MIPS, Eligibility, RCM