Healthmonix Advisor

CMS Admits to MIPS Scoring Errors, Extends Deadline

Posted by Christina Zink on September 26, 2018

In a recent update on 2017 MIPS Performance Feedback, CMS announced that they have identified errors in their scoring logic. CMS wrote that their targeted review process “worked exactly as intended, as the incoming requests quickly alerted us to these issues and allowed us to take immediate action.”

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Topics: MACRA & MIPS, CMS

Analysis Shows MSSP ACOs Saved Twice As Much As CMS Reported

Posted by Christina Zink on September 13, 2018

CMS estimates that between the 2013 and 2015 performance years, accountable care organizations (ACOs) in the Medicare Shared Savings Program (MSSP) saved $954 million. But according to a new analysis from Dobson DaVanzo & Associates, commissioned by the National Association of ACOs (NAACOS), they actually saved $1.84 billion—almost twice as much.

The analysis also found that MSSP delivered net savings of $541.7 million for 2013-2015 after accounting for shared savings bonuses; this is in contrast to the CMS benchmark calculation, which found that the organizations increased Medicare spending by $344.2 million.

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Topics: CMS, ACO, APMs

CMS Proposes New Changes to ACOs Under MSSP

Posted by Christina Zink on August 17, 2018

In a new proposal titled “Pathways to Success,” the Centers for Medicare & Medicaid Services (CMS) has laid out a modified set of participation options for ACOs (accountable care organizations) in the Medicare Shared Savings Program (MSSP). The proposed participation options would 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: CMS, ACO, Policy, APMs

CMS Has Released MIPS Feedback Reports: What To Do Next

Posted by Usman Safdar on July 19, 2018

It’s that time of year again: CMS has released final QPP performance feedback for 2017, including final scores and payment adjustment information. Here at Healthmonix, we believe in turning data into outcomes, taking control of performance, and driving revenue through value-based payments—which is why, now that you have access to your feedback, we’re outlining a few important next steps your practice can take to use that feedback in a meaningful way.

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Topics: PRO Tips, MACRA & MIPS, CMS

CMS Proposes Overhauling Meaningful Use: 4 Important Takeaways

Posted by Christina Zink on May 3, 2018

On Tuesday April 24th, CMS released a proposed rule which essentially overhauls the Medicare and Medicaid Electronic Health Record Incentive Programs (also known as the “Meaningful Use” program). The proposed rule includes updates to Medicare payment policies and rates under the Inpatient Prospective Payment System (IPPS) and the Long-Term Care Hospital (LTCH) Prospective Payment System (PPS). Here are five things you should know about the proposed changes:

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Topics: CMS, Interoperability, Policy, ACI Performance Category, PI Performance Category

One Important Takeaway From HIMSS 2018

Posted by Lauren Patrick on March 15, 2018

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.

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Topics: CMS, Industry insights

Interested in providing feedback to CMS about the burden that MIPS places on your practice?

Posted by Lauren Patrick on February 25, 2018

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).

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

CMS Launches 'Patients Over Paperwork' Initiative

Posted by Lauren Patrick on January 11, 2018

In late October, CMS launched a new initiative, Patients Over Paperwork, targeted to reduce unproductive regulatory burdens on health care providers and increase efficiency. CMS Administrator Seema Verma announced the initiative during a stakeholder meeting with more than 30 industry groups.

The initiative is potentially wide reaching, affecting a broad range of regulations surrounding practices such as prior authorizations, documentation of evaluation and management codes, OIG audits, and EHR requirements.

According to Verma, this has already touched the QPP final rule for 2018. As an outcome of this initiative, the QPP final rule includes policies that exclude individual MIPS eligible clinicians with less than or equal to $90,000 in Part B allowed charges or less than or equal to 200 Part B beneficiaries.

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Topics: CMS

CMS Launches 'Meaningful Measures' Initiative

Posted by Lauren Patrick on January 4, 2018

On October 30, CMS Administrator Seema Verma announced the Meaningful Measures initiative, which is intended to streamline quality reporting. This initiative is meant to address common criticisms of today’s performance measures, including their excessive focus on evaluating processes and the lack of alignment between programs. According to Verma, “Meaningful Measures will involve only assessing those core issues that are the most vital to providing high-quality care and improving patient outcomes.”

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Topics: CMS

How To Survive Year One of MIPS

Posted by Christina Zink on July 14, 2017

We are now in the seventh month of the new Merit-Based Incentive Payment System (MIPS), and the majority of MIPS-eligible clinicians still feel completely unprepared for success. With complicated and changing regulations, ensuring compliance can be a long and arduous process. Like most sizable goals, MIPS is best digested in small pieces, but it is hard to tell where to start sometimes. That is why we are going give you an order of operations to follow to ensure MIPS survival.

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Topics: PRO Tips, MACRA & MIPS, CMS, Eligibility