Healthmonix Advisor

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.

CMS estimates that between the 2013 and 2015 performance years, accountable care organizations (ACOs) in the Medicare Shared Savings Program (MSSP) saved $954 million. But according to a new analysis from Dobson DaVanzo & Associates, commissioned by the National Association of ACOs (NAACOS), they actually saved $1.84 billion—almost twice as much.

The analysis also found that MSSP delivered net savings of $541.7 million for 2013-2015 after accounting for shared savings bonuses; this is in contrast to the CMS benchmark calculation, which found that the organizations increased Medicare spending by $344.2 million.

You have been dealing with the bureaucracy behind quality reporting for years - silly questions with no relevance to your field or specialty, EMRs changing the way measures are recorded, CMS changing requirements during the reporting period. It’s hard enough to get your fingers around the changes as a manager or provider, but imagine the confusion on your staff’s side! Plus, they don’t have the incentive of financial responsibility or a reputation to uphold.

So, how do we get their buy-in?

The tracks of the Medicare ACO model vary greatly, but have been steadily gaining in prevalence since their launch in 2011. Despite the steady increase in ACO participation, most groups are staying at the Track 1 level. In fact, in 2018, 460 of the 649 ACOs existed at the Track 1 level.

The new proposed rule for 2019 features a lot of changes to the Quality Payment Program, but CMS has also announced changes impacting Medicare reimbursement in general. One big change proposed would affect how much money a clinician receives for billing office or outpatient Evaluation and Management (E&M) visits for new and existing patients.