Healthmonix Advisor

The Healthmonix team joined Accountable Care Organization (ACO) leaders throughout the country at the National Association of ACOs (NAACOS) Spring Conference at the beginning of May in Baltimore. There were many great discussions and presentations during the conference, but the hot button topic was eCQM / MIPS CQM reporting. The overwhelming sentiment from the conference is that eCQM reporting is a challenge that all ACOs are struggling with.

The Centers for Medicare & Medicaid Services (CMS) provided strong language to ACOs saying that the timeline for mandatory eCQM / MIPS CQM reporting is not going to change.  CMS encouraged ACOs to use the program years of 2023 and 2024 for strategic preparation and building their infrastructure in advance of the mandatory transition in 2025. 

Quality measures are tools used to improve patient care in a standardized way. Each year, the Centers for Medicare & Medicaid Services (CMS) publishes new measures aimed at measuring identified gaps in care in the healthcare sector. 

As we dive into the world of quality measures and their crucial role in enhancing patient care you can also check out our webinar on MIPS Reporting where we give you strategies for measure selection and building better workflows for this years reporting. 

MIPS reporting can be a daunting task for large practices. With multiple providers, patients, and quality measures to consider, it's essential to have a clear plan for success. Read on for our expert tips, and check out our latest webinars for more information. 

Explore the options for 2023 and look forward to 2024! 

In 2023, MIPS Value Pathways (MVPs)present a new and challenging reporting option for many providers. There are twelve available MVPs focused on specialties such as Emergency Medicine, Oncology, Hematology, Cardiology, Internal Medicine, Family Medicine, Rheumatology, Neurology, Neurosurgical, Vascular Surgery, Orthopedic Surgery, Nephrology, Anesthesiology, Preventive Medicine, and Geriatrics. 

While MVPs can be helpful for reporting, they also pose some challenges.

The Centers for Medicare and Medicaid Services (CMS) have initiated the development of a Universal Foundation of quality measures to improve healthcare quality and transform care.

CMS operates more than 20 quality programs, each with its own set of quality measures. The lack of alignment across these programs has contributed to challenges for clinicians, facilities, and health insurers in prioritizing meaningful outcomes for patients.

By identifying CMS's priority areas for measurement and revealing gaps, the Universal Foundation will evolve over time, with the intent of reducing provider burden and improving patient outcomes.

MIPS, the Merit-Based Incentive Payment System, is evolving. CMS has laid out a plan to increase quality of care while controlling costs, and all Medicare providers are expected to participate in eligible alternative payment models by 2030.  

In this blog post, we'll discuss the changes for 2023 and how small practices can maximize their scores and reimbursement.

Back in January of 2021 our CEO, Lauren Patrick, wrote "MVPs – Will they replace ‘traditional’ MIPS?"  At that time there were a lot of questions about how CMS would implement their new reporting framework, MIPS Value Pathways (MVPs).  Starting with the 2023 Program Year (PY), MIPS eligible providers have two pathways they can take to satisfy their obligations.  In this blog, I will review what an MVP looks like and how you may want to implement them within your practice. 

The 2023 Physician Fee Schedule (PFS) Final Rule was released in November 2022, finalizing many of the promised features of accountable care organizations (ACO) quality reporting.  A couple weeks ago, I wrote about the Quality reporting requirements and Healthmonix's strategies to approach the upcoming changes. For Part 2 of this discussion, I will be introducing the new Health Equity Adjustment and why it will impact quality reporting moving forward. 

Part 3 will cover the move from all or nothing scoring to a scaled approach. 

Once again, if you are a visual learner, you can get most of this information from  our latest webinar. 

If you are a dermatology practice, you probably breathed a sigh of relief when the Centers for Medicare & Medicaid Services (CMS) announced that dermatologists, along with many other specialists, would no longer be attributed patients for the Total per Capita Cost (TPCC) measure, as part of the Cost component of the Merit-based Incentive Payment System (MIPS).  However, in 2022, CMS introduced a Melanoma Resection Cost measure that is attributed to those specialists that perform these resections. So the Cost category is back for many dermatologists.  Even if this is the only Cost measure that is attributed to your practice, it is worth 30 of your total 100 MIPS points - as much as all your Quality measures combined!

With the release of the 2023 PFS Final Rule, the Centers for Medicare & Medicaid Services (CMS) finalized most of the proposed changes for the QPP / Merit-based Incentive Payment System (MIPS) program that had been released in the Proposed Rule last July.  

We are seeing that while the payment threshold is holding at 75 points, it can be tougher to achieve that threshold score with the changes in the program for 2023.