Healthmonix Advisor

Note: This article will update as we learn more, and to reflect any changes that may happen before the rule is officially published to the Federal Register on November 23, 2018. To view the entirety of the final rule, view the unpublished pdf version.

In August, the Centers for Medicare and Medicaid Services (CMS) released their proposed rule titled “Pathways to Success,” which outlined significant changes to the Medicare Shared Savings Program (MSSP) that encourage ACOs to move more quickly from one-sided to two-sided risk models. The proposed participation options for the MSSP--the largest ACO model with 561 participants--no longer include an “upside-only” risk model; instead, ACOs would be required to select one of two tracks, both of which ultimately include some downside risk.

EHRs have undoubtedly already changed the way healthcare works in America, and many of these changes have been for the better. Improved workflows and care delivery, enabled through EHR technology, are in many cases key to improving both patient and public health outcomes. But in the face of increasing requirements for providers, and the ever-looming need for health systems to justify their investment, EHRs must recognize that demand is high for a product that continues to improve and keep up with the changing times.

• I’m seeing a patient for dermatitis – Why do I need their BMI?
• I’m seeing a patient for a colorectal screening – How is it going to help me if they got their flu shot?
• I’m a Specialist. Why is it my job to ask these questions?

I encountered these questions all the time as a MIPS consultant within the specialty market. I spent the past 6 years working with providers who just want to provide better care to their patients. They didn’t mind participating in the programs, but they were not convinced there was much value.

In the pursuit of value based care, interoperability is key. But is it achievable in the current healthcare landscape? And if not, what would we have to do to bridge that gap?

Net Health, the leader in software solutions for specialized outpatient care, has partnered with Healthmonix to provide streamlined Merit-Based Incentive Payment System (MIPS) reporting for its WoundExpert customers.  The companies will collaborate to simplify the reporting process, improve patient health outcomes and maximize revenue. 

There’s no doubt that MIPS involves a learning curve. The program’s rules can be complex and can require cumbersome initial investments of time and money, leading many doctors to try to avoid it altogether. But MIPS matters, and the most successful doctors in coming years will be those who invested wholeheartedly in the reporting process. Here’s why.

In a recent update on 2017 MIPS Performance Feedback, CMS announced that they have identified errors in their scoring logic. CMS wrote that their targeted review process “worked exactly as intended, as the incoming requests quickly alerted us to these issues and allowed us to take immediate action.”

According to the proposed rule for 2019, use of 2015 Certified EHR Technology (CEHRT) will be required in the 2019 performance year. Many EHRs have already become 2015 CEHRT or plan to do so before next year, but not all have.

If you are a clinician trying to stay compliant and meet MIPS reporting requirements, there are a few things you should keep in mind to make sure that this new change won’t negatively affect you.

Conferences are a reality of business life.  Whether this is your first conference or your 10th, it's easy to be overwhelmed by the exciting blend of travel, free meals, sessions, contacts, conversations, and business cards.  Truth be told, conferences are a great way to learn from experts in your field and an essential networking opportunity (yes, even for introverts!). As we prepare for the upcoming MGMA Conference, we want to share some tips and tricks for new and experienced conference attendees. From the pre- conference planning to the post- conference follow up, we're here to provide you with 10 tips and tricks to get the most out of your next conference.