Healthmonix Advisor

Impact of New Health Equity Adjustment on ACO Quality Reporting

Posted by Mike Lewis on January 20, 2023

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. 

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Topics: MACRA & MIPS, ACO, APM Performance Pathway, 2022 PFS Final Rule, Accountable Care Organization, health equity, Health Equity Adjustment

2023 PFS Final Rule: All-Payer Quality Reporting is Here

Posted by Mike Lewis on November 16, 2022

 

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.

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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

Insights from the NAACOS Fall Conference On eCQM/MIPS CQM Reporting

Posted by Lauren Patrick on September 19, 2022

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.

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

Health Equity Scoring to Push ACOs to Begin eCQM/MIPS CQM reporting in 2023

Posted by Steve Tyson on September 16, 2022

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.

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

Key Takeaways from the NAACOS 2021 Fall Conference

Posted by Lauren Patrick on October 15, 2021

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.

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

Registry Impact on Shared Savings in the APM Performance Pathway (APP)

Posted by Lauren Patrick on May 14, 2021

For ACOs participating in the Medicare Shared Savings Program (MSSP), CMS is implementing rules in 2021 and 2022 for quality reporting which include a sweeping change. This change will require a new reporting approach, in order to aggregate data from electronic health record systems used across an ACO for all patients seen by any provider, regardless of payer or participation in the ACO. In a recent survey, nearly 75% of the ACO respondents indicated concern with the challenge of these requirements. The Web Interface reporting is being sunset, and ACOs need to devote attention to determining their strategy for transitioning quality reporting. Success will require thoughtful planning and experienced system implementation.

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Topics: ACO, APM Performance Pathway, Medicare Shared Savings Program

ACOs Leave MSSP After "Pathways To Success"

Posted by Christina Zink on May 17, 2019

Between 2018 and 2019, 74 of Medicare’s 561 accountable care organizations (ACOs)—or 13%—left the program, according to research by Leavitt Partners. The same research also found that 26% of ACOs that reached the end of their three-year agreement opted to not renew it at the end of 2018.

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Topics: CMS, ACO, APMs

New CMS Toolkit: 5 Care Coordination Strategies For ACO Success

Posted by Christina Zink on May 2, 2019

A new CMS toolkit, released through the CMS ACO learning system, shows five innovative care coordination strategies that have helped Medicare ACOs find success through shared savings.

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Topics: CMS, ACO, APMs

Breaking: CMS Measure Change May Affect ACO Shared Savings

Posted by Christina Zink on April 12, 2019

According to a recent announcement from the National Association of ACOs (NAACOs), CMS failed to adequately communicate significant changes to measure ACO-17, Preventive Care and Screening, Tobacco Use- Screening and Cessation Intervention, until after 2018 quality reporting had begun. NAACOs believes that CMS’s failure to communicate these changes will result in unintended consequences such as lowered or even eliminated shared savings rates for ACOs that consequently received a lower performance score or failed to meet quality standards.

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Topics: CMS, ACO, Policy, APMs

Lawmakers Push Back on Proposed Changes to MSSP

Posted by Christina Zink on October 31, 2018

In August, the Centers for Medicare and Medicaid Services (CMS) released their proposed rule titled “Pathways to Success,” which outlined significant changes to the Medicare Shared Savings Program (MSSP) that encourage ACOs to move more quickly from one-sided to two-sided risk models. The proposed participation options for the MSSP--the largest ACO model with 561 participants--no longer include an “upside-only” risk model; instead, ACOs would be required to select one of two tracks, both of which ultimately include some downside risk.

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Topics: ACO, Policy