Healthmonix Advisor

Last week’s 2018 HIMSS Conference presented, as every year, a profusion of insights into the current landscape of healthcare technology. With over 300 education sessions, 1,300 vendors, and hundreds of special programs and events, a HIMSS conference can be hard to boil down into just a few key points. Still, I wanted to share one particularly salient impression that stuck with me after I attended, one that I think anyone with an interest in healthcare should stick a pin in.

 The 2018 winter Olympics wrapped up this weekend in PyeongChang, leaving us at Healthmonix contemplating the many analogous connections between the Olympian athletes and providers of value-based care. So in honor of this year’s champions, we’re laying out why you should follow their example and go for the gold:

1. If you want to place, strive for peak performance.

Apply to help CMS in its new study, running from April 2018 through March 2019, and make your voice heard.

CMS is looking for groups and individuals that are eligilbe for MIPS to help study the burden that the MIPS program, particularly the Quality component, place on eligible clinicians. In return, successful participants will receive full credit for the Improvement Activity component of MIPS this year (2018).

In year two of MIPS and beyond, CMS is including an Improvement score for Quality and Cost measures. This week we take a deep dive into what this score entails, as well as what you need to know to keep yours ahead of the curve.

Hospital readmissions can be bad news for patients, but they can also be bad news for a hospital’s bottom line. Readmissions cost $41.3 billion overall, a majority of which—about $26 billion annually—is paid by Medicare. Moreover, as much as $17 billion of Medicare-paid readmissions are considered to be avoidable.

But why would they care? If a clinician moves to a new practice, wouldn’t they receive the score, and adjustment, for that new practice? Unfortunately for clinicians looking to start fresh, the answer is no.

In late October, CMS launched a new initiative, Patients Over Paperwork, targeted to reduce unproductive regulatory burdens on health care providers and increase efficiency. CMS Administrator Seema Verma announced the initiative during a stakeholder meeting with more than 30 industry groups.

The initiative is potentially wide reaching, affecting a broad range of regulations surrounding practices such as prior authorizations, documentation of evaluation and management codes, OIG audits, and EHR requirements.

According to Verma, this has already touched the QPP final rule for 2018. As an outcome of this initiative, the QPP final rule includes policies that exclude individual MIPS eligible clinicians with less than or equal to $90,000 in Part B allowed charges or less than or equal to 200 Part B beneficiaries.

Depending on your performance and your desire to maximize your reimbursement in 2019 (who doesn’t want more revenue?), there are a number of options available in final submission of your MIPS data to CMS. All of these choices can seem overwhelming, but Healthmonix is here to help! Read on to find out what choices you'll face and how to make the best ones for your practice.