Healthmonix Advisor

As MACRA barrels into its second full year of implementation, we’re noticing mixed reactions to the reporting process. Some practices and organizations have thrown their best efforts into reporting and earning an incentive, while others are only interested in finding the easiest way to get compliant and avoid any penalty on their Medicare Part B reimbursements.

Topics: PRO Tips, MACRA & MIPS, RCM, VBC

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.

Topics: CMS, Industry insights

On February 9th, a new Congressional spending bill was signed into law, ending our second government shutdown in less than a month. The Bipartisan Budget Act of 2018 keeps the government funded until March 23, boosts spending on military and domestic programs for two years, extends the debt ceiling, increases aid for recent natural disasters and to fight the opioid crisis, and extends the Children’s Health Insurance Program (CHIP) for an additional four years (on top of the six years authorized earlier in 2018).

Topics: MACRA & MIPS, Policy

 

 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.

Topics: PRO Tips, VBC

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).

Topics: MACRA & MIPS, CMS, Quality Performance Category, Administrative Burden

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.

Topics: MACRA & MIPS, Policy, Quality Performance Category, Cost Performance Category

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 opt for reporting in “easy mode” during the transition years to avoid the hassle. And for 2017, easy mode is about as easy as it gets.

Topics: PRO Tips, MACRA & MIPS

Living squarely in Eagles territory with the big game less than a week away, I've noticed several correlations between the journey to becoming a winning football team and the implementation of a winning value-based care strategy.  A successful transition to VBC requires time, deliberation, and dedication to improving quality outcomes.  Sharing a vision isn't enough. There must be a greater commitment by the whole team to do what is necessary to achieve greatness.  Nothing good ever comes easily, so the key to winning is to keep your eye on the prize.  Here are just a few pro-tips for paving your way to victory:

Topics: PRO Tips, VBC

 

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.

Topics: PRO Tips, Hospitals & Health Systems, VBC

 

Yes, it may be that important. My prediction is that practices, networks, and health systems will start to pay more attention to MIPS scores during the process of hiring new clinicians. In fact, at Healthmonix we have already been asked about this several times in 2017.

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.

Topics: PRO Tips, MACRA & MIPS, Physician Compare, Industry insights