Healthmonix Advisor

 

The 2023 Physician Fee Schedule (PFS) Final Rule was released on November 6, 2023 and included over 3,000 pages of the Centers for Medicare & Medicaid Services (CMS) regulations and rulings for the 2023 year. While there is a ton of information to cover the entire rule, I would like to share what you need to know about the impact on the Medicare Shared Saving Program (MSSP) for Accountable Care Organizations (ACOs). In the first of this three-part series, I will cover Quality Reporting Requirements and Strategy. Subsequent blogs will cover Introduction to the Health Equity Adjustment and The Move from All or Nothing Scoring to a Scaled Approach .

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

Topics: ACO, APM Performance Pathway, Medicare Shared Savings Program, Accountable Care Organization, MIPS CQMs, eCQMs, 2015 Edition CEHRT, certified electronic health record technology, 2015, 2023 PFS Final Rule

As we prepare for the final months of 2022, are you prepared to be successful in the Promoting Interoperability (PI) performance category for the 2022 reporting year? Merit-based Incentive payment System (MIPS) experts know that PI data must be reported for any consecutive 90-day period throughout the year. October 3rd begins the last 90 days of the calendar year, and Healthmonix wants to make sure you are positioned for success. This blog will give an overview of the performance category and offer some helpful tips about how to proceed.  

Topics: PI Performance Category, 2023 Proposed Rule, Promoting Interoperability, 2015 Edition CEHRT, 2015 Edition Cures Update certification, certified electronic health record technology

Electronic health record (EHR) companies have their single biggest technical update to complete by September 2023, as announced in a recent a meeting with the Deputy National Coordinator of Health Information Technology.  All EHR enhancements that are required to comply with the 2015 Cures Act standards must be completed by September 2023.   All data that is shared must be normalized by that time and EHR technology vendors are required to certify with real world testing.  

Topics: Interoperability, EHR, 2015 Edition Cures Update

If you are managing a Medicare Shared Savings Program accountable care organization (MSSP ACO), you have heard the mandate from the Centers for Medicare & Medicaid Services (CMS) to move to eCQM/CQM reporting, replacing the Web Interface reporting.  You may also be aware of the significant pushback that ACOs, collectively and independently, have provided to CMS.  At this year’s fall National Association of ACOs (NAACOS) conference, the tenor changed to accepting the move, optional in 2022 through 2024, but required in 2025.

Topics: ACO, APM Performance Pathway, Accountable Care Organization, MIPS CQMs, eCQMs

The 2023 Provider Fee Schedule Proposed Rule was released in July and there are changes that accountable care organizations (ACOs) need to be aware of. This blog will focus on the most important changes from a quality reporting perspective.

Topics: ACO, APM Performance Pathway, 2023 Proposed Rule, health equity

As you report your MIPS data, it can feel like a lot of work with little ROI for the last two years. But wait. Sometimes we need to step back and evaluate the bigger picture. While we often focus on "getting the job done", there are changes in the healthcare economy that are occurring that are strategic.

Topics: MACRA & MIPS, APMs, VBC, Value-Based Care

On November 2, 2021, the Centers for Medicare & Medicaid Services (CMS) released the 2022 Physician Fee Schedule (PFS) Final Rule which governs MIPS and other quality payment programs. Anticipated changes were made to MIPS, making the program more challenging in 2022 and signaling additional changes to the program in coming years.

Topics: MACRA & MIPS, Quality Performance Category, IA Performance Category, Cost Performance Category, PI Performance Category, MIPS Value Pathways, 2022 PFS Final Rule

With the release of the 2020 feedback report detailing the 2.2% maximum possible payment adjustment and the release of the 2022 Final Rule, CMS has demonstrated that MIPS will be both financially rewarding and challenging, in terms of reporting requirements, in 2021 and beyond.

   

Topics: Quality Performance Category, IA Performance Category, Cost Performance Category, PI Performance Category, 2022 PFS Final Rule

The NAACOS Fall 2021 Conference was the first live meeting that the Healthmonix team attended since HIMSS 2020 was cancelled in March of that year. It was certainly reinvigorating to meet in person, discuss the state of payment models, and hear from CMS regarding their vision.

Topics: CMS, ACO, Industry insights, 2021 PFS Proposed Rule

With the release of the 2020 feedback report detailing the 2.2% maximum possible payment adjustment and the release of the 2022 Proposed Rule, MIPS participants find themselves wrestling with lingering disappointment from participation in the program in previous years, and resistance to the idea that MIPS will be financially rewarding and challenging, in terms of reporting requirements, in 2021 and beyond.    

This is the second in a series of blog posts on the 2020 payment adjustment and the 2022 Proposed Rule, that will address this sense of disappointment and show how the future of MIPS will contain much more rigorous program requirements and create greater financial rewards.  To see financial and program success, you will need to be prepared to meet the new challenges.  We have the guidance you need to succeed in 2021 and beyond.    

Topics: MACRA & MIPS, Quality Performance Category, Cost Performance Category, 2022 PFS Proposed Rule