This year’s HLTH 2024 conference delivered on its promise to push the boundaries of what’s possible in healthcare. It was a chance to connect with peers, challenge the status quo, and dig into the trends that will reshape our industry. From the innovative — but so needed — concept of socially prescribed care to the potential ripple effects of the upcoming election, HLTH 2024 was a window into a rapidly changing landscape.
Here’s what stood out to me.
Topics: Health IT
2024 stands as a pivotal year for healthcare providers, marking the end of leniency granted since the COVID-19 Public Health Emergency began. Participation in the Quality Payment Program (QPP) and the Merit-based Incentive Payment System (MIPS) is no longer optional — if providers fail to engage, they’ll face penalties.
Topics: Healthmonix
For the first time since the COVID-19 Public Health Emergency (PHE), all eligible clinicians must engage with the MIPS program or face a stark 9% cut in Medicare Part B claim reimbursements. With the stakes raised this year, scores have become pivotal. Additionally, the threshold for avoiding penalties has jumped in recent years, making high scores a coveted achievement.
Within MIPS, the quality component demands each clinician or group to report on 6 quality measures. The scoring landscape, however, has shifted:
Topics: Healthmonix
In the dynamic landscape of healthcare technology, data security and compliance are paramount. As we witness the rapid evolution of digital health solutions, patients and healthcare providers alike demand robust safeguards to ensure the confidentiality, integrity, and availability of sensitive information.
We're thrilled to announce that Healthmonix, a leading value-base care organization in healthcare technology, has achieved the prestigious HITRUST certification, reinforcing our commitment to excellence in data security.
Topics: Healthmonix
Background: Under the Quality Payment Program (QPP), eligible clinicians face payment adjustments determined by their performance in the Merit-Based Incentive Payment System (MIPS) or choose to participate in the Advanced Alternative Payment Model (APM) track. Those in MIPS see their payments increased, maintained, or decreased based on relative performance in four categories: Quality, Cost, Promoting Interoperability, and Improvement Activities.
Clinicians participating in an Advanced APM are exempt from MIPS and were initially qualified for a 5% bonus payment. However, after the expiration of the 5% bonus, Congress reauthorized the bonus at a reduced rate of 3.5% for the year 2023. Additionally, the Centers for Medicare & Medicaid Services (CMS) has introduced a new alternative to traditional MIPS known as the MIPS Value Pathways (MVPs), which is a voluntary option for eligible clinicians.
The program continues to evolve at a macro level, as CMS has a vision to move providers out of ‘traditional MIPS’ and into other reporting options such as APP for Shared Savings participants, MVPs for those still in fee for service, and APMs for other provider programs. In addition, CMS continues to pursue the Universal Foundation. Providers need to be prepared for bigger shifts in their quality reporting strategies as CMS aligns programs under the National Quality Strategy.
Below we explore some of the key takeaways from the 2024 PFS Final Rule impacting the QPP program.
In the 2024 Medicare Physician Fee Schedule (PFS) Final Rule released yesterday, CMS is emphasizing getting the Quality Payment Program (QPP) “back on track with the trajectory we had planned before the public health emergency (PHE)”. They’re focused on ensuring that the program resumes its intended progress, which was interrupted during the PHE over the last few years.
Here's an initial breakdown of what this means.
Quality scores matter!
The Medicare Shared Savings Program (MSSP) saved $1.8 billion for Medicare in 2022, according to last month’s announcement by the Centers for Medicare & Medicaid Services.1 This marks the second-highest yearly savings since the program’s start. It further underscores the program’s track record of consistently generating savings and delivering high-quality performance for the sixth consecutive year, as noted by CMS.
Topics: ACO, MIPS Reporting
ACOs have encountered challenges with aggregating, matching, and deduplicating extensive, disparate patient data required under the eCQM and MIPS CQM quality measure collection types. Patient matching and deduplication are needed to accurately calculate quality metrics from data across multiple practices and EHR instances.
Read on as we unravel the challenges and several methods to overcome these challenges.
Topics: MACRA & MIPS, MIPS CQMs, MIPS Reporting
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
