Healthmonix Advisor

Lauren Patrick

Lauren is the founder and president of Healthmonix. She brings a vision of assisting organizations and providers in improving the quality of healthcare through innovative approaches. Lauren has a background as a consultant at Ernst and Young and holds a Master’s Degree in Computer Engineering. She loves to bike and kayak!
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Recent Posts

MIPS - How Many Options Do I Have?

Posted by Lauren Patrick on March 10, 2021

As we move into 2021 and beyond, we see CMS putting some real teeth into the Merit-based Incentive Payment System (MIPS) program.  This is the first year where we see more than two percent incentives possible.  Exemptions and exclusions are narrowing.  Participants in other value-based programs are being forced into MIPS reporting because of higher thresholds for exclusion and elimination of other reporting options.

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Topics: MACRA & MIPS, MIPS Value Pathways, APM Performance Pathway

MVPs - Will they replace 'traditional' MIPS?

Posted by Lauren Patrick on January 28, 2021

There has been much talk around MVPs in the CMS quality reporting arena. MVP means MIPS Value Pathway, and it’s a reporting framework that CMS is communicating as (a) the next evolution of MIPS and (b) a transition tool for getting to other alternative payment modules. As CMS continues to define and refine their vision of the MVPs, they have started to call the current framework 'traditional MIPS' to prepare for the inclusion of the MVP option. You’ll see this when you visit the QPP site.

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Topics: MACRA & MIPS, CMS, 2021 PFS Proposed Rule, MIPS Value Pathways

MIPS 2021 Incentives and Penalties | We're Entering Prime Time

Posted by Lauren Patrick on January 14, 2021

For years, we’ve heard that the Merit-based Incentive Payment System (MIPS) will provide a noticeable incentive for participants in this Medicare FFS program. And for years, there have been reasons why that has not occurred. First, CMS wanted to ‘start slow’ with the MIPS program in 2017 and 2018, so the caps on penalties and incentives were small. Then the potential penalties and incentives were raised, but the threshold for qualifying for an incentive remained low. This, coupled with the program’s budget neutrality meant there was not much revenue to distribute to high performers. Then COVID-19 negated much of the program for the last two years. So here we are, in year five, and we see that the program, for the first time, will have a significant downside and upside potential.

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Topics: MACRA & MIPS, CMS, APMs, Cost Performance Category, 2021 PFS Final Rule

2020 MIPS Reporting Period – Did it Get Cut in Half?

Posted by Lauren Patrick on July 30, 2020

The quick answer is NO!

There has been quite a bit of discussion, and some press, about the reporting period for MIPS for 2020. I have seen a few articles saying that no data reflecting services provided January 1, 2020 through June 30, 2020 will be used in the Center for Medicare & Medicaid Services (CMS’s) calculations for the Medicare quality reporting and value-based purchasing programs. However, if you read the Quality Payment Program – COVID-19 Response, Updated 6/24/2020, there is no mention of an all-inclusive change to the reporting period.

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Topics: MACRA & MIPS, CMS, Industry insights

How will the QPP MIPS program be affected by the COVID-19 pandemic?

Posted by Lauren Patrick on May 18, 2020

We know the current regulatory updates for the Quality Payment Program (QPP) program. To date,  the Centers for Medicare & Medicaid Services (CMS) has issued many changes. The 2019 MIPS reporting requirement had an extended deadline and options for hardship exemptions. The 2020 MSSP program reporting period had many changes in both of the interim final rule with comment periods (IFCs) issued by  CMS, at the end of March and the end of April. CMS has also added a COVID-19 improvement activity to the 2020 program, that provides full credit for the Improvement Activity category for MIPS, if an individual or 50% of a group (TIN) participates in clinical trial reporting. No changes to the reporting window or other parameters of the program have been issued.

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Topics: MACRA & MIPS, COVID-19

MIPS 2020 – Why and how to get started

Posted by Lauren Patrick on May 12, 2020

Are you wondering how MIPS reporting in 2020 will be affected by the COVID-19 pandemic?  Are you holding off reporting because you are uncertain as to the requirements for 2020?  Has the responsibility of MIPS reporting shifted with the impact of the pandemic on your organization?

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Reopening Your Medical Practice with Confidence

Posted by Lauren Patrick on May 11, 2020

Practice Recovery

As public health experts determine that it is safe to see patients, and governments lift stay-at-home restrictions, physician practices are challenged to strategically plan when and how best to reopen.  As the AMA points out, there are many components of reopening. 

When the time is right, it will be critical to be prepared to reopen, ready to communicate and live a new practice “normal”. In these uncertain times, making sure physical practice changes, staff training, workflow and supplies align, will be important for a successful reopening. Filling your schedule in safe and meaningful ways will help the practice sustain itself and your team. Marketing and communication to patients will help restore confidence and build trust.

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Topics: COVID-19, Practice Reopening

Practice Sustainability in the time of COVID-19

Posted by Lauren Patrick on April 19, 2020

Physician practices are confronting new operational and business challenges as a result of the COVID-19 pandemic. There is a mounting financial and administrative toll this pandemic has placed on practices, forcing all to adapt in a variety of areas.  Much of the conversation around COVID-19 has appropriately focused on addressing the pandemic and treatment of COVID-19 patients, however, we are also keenly aware of the other impacts on practices. 

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Topics: Cost Performance Category, ROI, COVID-19

CMS relaxes more rules around telehealth, allowing healthcare across state lines

Posted by Lauren Patrick on April 14, 2020

The Centers for Medicare & Medicaid Services (CMS) continues to relax regulations to enable hospitals, clinics and other providers to boost their front-line medical staff during the COVID-19  pandemic. This pandemic has created an urgency for expansion of the use of virtual healthcare to reduce the risk of spreading the virus. It has also created a need to relax practice restrictions and allow more flexible care practices to meet the needs of patients.

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Topics: CMS, Interoperability, Industry insights, Policy, Health IT, VBC, COVID-19

Quality Payment Program COVID-19 Response - Update April 6

Posted by Lauren Patrick on April 6, 2020

The Centers for Medicare & Medicaid (CMS) is working rapidly to update policies and allow healthcare providers to flexibly apply best practices in response to the COVID-19 pandemic.  Programs such as Hospitals without Walls and the existing Patients over Paperwork have been deployed.  Removal of barriers have resulted in exponential growth of telehealth and remote patient monitoring.   Advanced payments to healthcare providers are being provided to counter the effects of changing patterns of healthcare use,  reduction in elective procedure, increase in ICU utilization and other ongoing unanticipated changes.

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Topics: MACRA & MIPS, Quality Performance Category, COVID-19, submission