Healthmonix Advisor

Transparency is a vital aspect of the transition to quality care because it allows patients to make more informed healthcare choices. To this end, CMS has increased accessibility of physician information with the Physician Compare website, which publicly reports provider data including some quality measures. If you are a provider and want to assess or even optimize how you appear compared to your peers, you may have questions about how the Physician Compare website works and how to make sure it represents you accurately.

The American Health Care Act (AHCA), also known as Trumpcare, was narrowly passed through the House of Representatives on Thursday May 4th. On Thursday June 22nd, after a secretive seven-week revision process led by Majority Leader Mitch McConnell, a draft of the Senate version of the bill has been released. Following is a comparison of some of the important changes between the ACA (Obamacare) and both versions of the AHCA.

The 2018 Quality Payment Program proposed rule suggests significant changes to MIPS reporting. The changes proposed are aimed at easing the burden of reporting while increasing the meaningfulness of compliance. We have previously discussed new policies being introduced and changes compared to 2017 reporting. The 2018 proposed rule also suggests changes to the MIPS Performance Categories.

The 2018 MIPS Proposed Rule was just released by CMS, and it contains changes from the 2017 rule which providers may benefit from considering in relation to their reporting goals and strategies. In our last post we outlined various new proposals as well as new opportunities for bonus points in the MIPS final score. Here we clarify further changes from 2017, including updates on the low volume threshold, submission options, and the minimum performance period.

Yesterday afternoon, CMS posted CY 2018 Updates to the Quality Payment Program to the Federal Register, to be officially published at the end of this month. Many clinicians are still trying to wrap their heads around how to report MIPS in 2017. However, the release of the 2018 proposed rule is advantageous as aid deciding what to conquer in 2017, and which aspects of MIPS can be digested in the future. As the title suggests, this document also covers other Quality Payment Program tracks, like Advanced APMs. As the vast majority of healthcare providers are expected to be participating in MIPS for 2017 and 2018, we are just going to focus on the MIPS component of the proposed rule for now.

Maybe you’ve reported PQRS in the past and are already preparing to make the transition to MIPS this year. Or, maybe this year is the first time your practice plans to report. Either way, your method of reporting can help determine whether or not you achieve your quality and revenue goals, and the benefits and drawbacks of different methods must be weighed in relation to the unique needs of your practice. To give you a place to start, this post compares and contrasts some considerations related to two common submission mechanisms: EHR and Qualified MIPS Registry reporting.

With the beginning of June came the half-way point for the first year of MIPS reporting. While many providers haven't started reporting yet, a good number of clinicians have started early. We interviewed clinicians and practice administrators who have reported PQRS in the past via registry, are currently reporting through the MIPSPRO registry, and that represent a diverse demographic of MIPS eligible clinicians. 

The Improvement Activities Performance Category of MIPS is the the newest quality improvement initiative from CMS. Reporting this category is relatively simple, entailing only that eligible clinicians or groups attest to completing between one and four out of 92 pre-selected improvement activities. Selecting Improvement Activities and understanding how the impact your MIPS final score can be tricky.  Luckily, it doesn't have to be! 

During the first year of MIPS, it is deceptively easy to avoid the penalty. In a CMS blog post released a few weeks before the final rule was published, the Acting Administrator for CMS, Andy Slavitt, announced that there would be MIPS pacing options to allow eligible clinicians to ease into the program. The most basic level of reporting, referred to sometimes as the MIPS Test Option, is so simple to complete that it absolutely seems to good to be true. 

One of the trickiest aspects of the new CMS Quality Payment Program is understanding how to report MIPS as a group. MIPS group reporting is when a TIN of 2 or more providers decides to report their MIPS measures and activities on the group (TIN) level, rather than on the individual (TIN+NPI) level. This could be an advantage to a practice that has a few providers who struggle to find measures that are relevant to them personally, or a practice exercising the "test option" of MIPS reporting for 2017. Eligible Clinicians must report either individually or as a group consistently across all MIPS performance categories.