In the ever-evolving healthcare world, staying current is vital. Orthopedic surgery, particularly arthroplasty, has been at the forefront of the shift toward value-based care models. With certain procedures already subject to bundled payments for over a decade, the integration of cost measures within the Merit-Based Incentive Payment System (MIPS) is a game-changer.
Read on as we unravel the vital details of this essential aspect of modern healthcare performance assessment.
Topics: MACRA & MIPS, MIPS CQMs, MIPS Reporting
With 2022 MIPS final scores available, hospitals and health systems have seen the Cost category produce a major impact on their overall MIPS scores.
Before CMS added the Cost category to 2022 MIPS scores, hospitals had little insight into how it would impact MIPS scores. With scores out, we see that many hospitals and health systems were scored on over 10 Cost category measures. That’s a large amount of data to sift through and analyze.
Topics: MACRA & MIPS, MIPS CQMs, MIPS Reporting
In the 2024 Proposed PFS Rule released in July 2023, CMS outlined a new option for MSSP participants to report quality measures called the Medicare CQM option. CMS created this reporting option to address concerns raised by ACOs and others, while still transitioning ACOs toward digital quality measure reporting.
Read on to learn more about the new proposed option for MSSP participants.
Topics: MACRA & MIPS, MIPS CQMs, MIPS Reporting
With 2022 MIPS preliminary scores available, oncology practices are increasingly seeing how the Cost category negatively affects their overall MIPS scores.
Before CMS added the Cost category to 2022 MIPS scores, research hinted that oncology and other specialties with higher healthcare costs might face more adverse effects than other specialties. Numerous oncology practices opted for an Extreme and Uncontrollable Circumstances (EUC) exemption for the Cost category in 2022, mitigating the impact of cost measures on them.
Read on to learn more about how MIPS Cost scores are affecting Oncology practices.
Topics: MACRA & MIPS, MIPS Reporting, MIPS Cost
Discover the game-changing impact of the 2022 MIPS Final Score Preview period as we delve into the long-awaited return of Cost category scores after 3 years. The implications for providers' total MIPS scores are profound, and we have the insights you need to navigate this transformative shift.
Topics: MIPS Reporting
Last week, CMS confirmed that 2022 MIPS scores for eligible providers will include the Cost performance category. Per CMS:
“For the 2020 and 2021 performance periods, CMS reweighted the MIPS Cost performance category to 0% as a result of the COVID-19 public health emergency (PHE). For the 2022 performance period/2024 MIPS payment year (hereafter written as “2022 performance period”), CMS conducted an empirical analysis to assess whether any or all cost measures were continually impacted by the COVID-19 PHE and, if so, whether it would be appropriate for CMS to reweight the Cost performance category again under § 414.1380(c)(2) or to exclude any individual cost measures.
Read on to learn more about how these changes may affect your MIPS participation and payment year.
Topics: MIPS Reporting
Explore the options for 2023 and look forward to 2024!
In 2023, MIPS Value Pathways (MVPs)present a new and challenging reporting option for many providers. There are twelve available MVPs focused on specialties such as Emergency Medicine, Oncology, Hematology, Cardiology, Internal Medicine, Family Medicine, Rheumatology, Neurology, Neurosurgical, Vascular Surgery, Orthopedic Surgery, Nephrology, Anesthesiology, Preventive Medicine, and Geriatrics.
While MVPs can be helpful for reporting, they also pose some challenges.
Topics: MVPs
The Centers for Medicare and Medicaid Services (CMS) have initiated the development of a Universal Foundation of quality measures to improve healthcare quality and transform care.
CMS operates more than 20 quality programs, each with its own set of quality measures. The lack of alignment across these programs has contributed to challenges for clinicians, facilities, and health insurers in prioritizing meaningful outcomes for patients.
By identifying CMS's priority areas for measurement and revealing gaps, the Universal Foundation will evolve over time, with the intent of reducing provider burden and improving patient outcomes.
If you are a dermatology practice, you probably breathed a sigh of relief when the Centers for Medicare & Medicaid Services (CMS) announced that dermatologists, along with many other specialists, would no longer be attributed patients for the Total per Capita Cost (TPCC) measure, as part of the Cost component of the Merit-based Incentive Payment System (MIPS). However, in 2022, CMS introduced a Melanoma Resection Cost measure that is attributed to those specialists that perform these resections. So the Cost category is back for many dermatologists. Even if this is the only Cost measure that is attributed to your practice, it is worth 30 of your total 100 MIPS points - as much as all your Quality measures combined!
Topics: MACRA & MIPS, Cost Performance Category
With the release of the 2023 PFS Final Rule, the Centers for Medicare & Medicaid Services (CMS) finalized most of the proposed changes for the QPP / Merit-based Incentive Payment System (MIPS) program that had been released in the Proposed Rule last July.
We are seeing that while the payment threshold is holding at 75 points, it can be tougher to achieve that threshold score with the changes in the program for 2023.
Topics: Cost Performance Category, MIPS Value Pathways, eCQMs, Promoting Interoperability, certified electronic health record technology, 2023 PFS Final Rule, Merit-based Incentive Payment System, Improvement Activities
