Healthmonix Advisor

What to Do in the Last 90 Days of MIPS 2020

Posted by Phillip Spence on September 30, 2020

The last 90 days of the year. Many might be ready to say goodbye to 2020 as a year filled with challenges, adjustments and ever-shifting expectations in our personal and professional lives. For those clinicians who are eligible for participation in the Merit-Based Incentive Payment System (MIPS), the last 90 days of the year also represents the beginning of some measurement periods and the final opportunity to improve in others.

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Topics: PRO Tips, MACRA & MIPS, Quality Performance Category, IA Performance Category, Cost Performance Category, PI Performance Category

The Increasing Importance of the MIPS Cost Performance Category

Posted by Matt Major on June 2, 2020

Blog - MIPS Cost Performance

Quality and Cost are two fundamental focus areas in the Volume to Value-Based Care transition.  The Centers for Medicare & Medicaid Services (CMS), seeks to incentivize higher quality care at a lower cost through programs like MIPS.  In recent years, the primary focus of MIPS has been Quality reporting, however Quality and Cost will be equally weighted in 2022.  Mandated increases and lack of insight into current MIPS scores make it a top priority for practices to learn how Cost impacts their revenue.

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Topics: MACRA & MIPS, Cost Performance Category

Practice Sustainability in the time of COVID-19

Posted by Lauren Patrick on April 19, 2020

Physician practices are confronting new operational and business challenges as a result of the COVID-19 pandemic. There is a mounting financial and administrative toll this pandemic has placed on practices, forcing all to adapt in a variety of areas.  Much of the conversation around COVID-19 has appropriately focused on addressing the pandemic and treatment of COVID-19 patients, however, we are also keenly aware of the other impacts on practices. 

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Topics: Cost Performance Category, ROI, COVID-19

Everything You Need To Know About MIPS Cost in 2019

Posted by Christina Zink on July 18, 2019

The CY 2019 Medicare Physician Fee Schedule Final Rule involves a slew of regulatory changes that will apply to the 2019 performance year. Of course, wading through the final rule to find and understand the most important features of the policy can be grueling; but you’re in luck, because we’ve already done it so you don’t have to! In today’s blog, we’re focusing on the MIPS Cost category.

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Topics: MACRA & MIPS, Policy, Cost Performance Category

Have You Heard Of Patient Relationship Codes? They May Soon Impact Your Bottom Line.

Posted by Lauren Patrick on January 18, 2019

A recent perspective article in the New England Journal of Medicine begins with a bold claim: that patient relationship categories and billing-code modifiers, which clinicians have been able to voluntarily submit since January 1, 2018, “may be one of the least known but most important provisions of the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA).” In today’s blog we’ll explore how patient relationship codes may, as the article predicts, end up impacting reimbursement.

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Topics: MACRA & MIPS, Policy, Cost Performance Category

Everything You Need To Know About MIPS Facility-Based Quality and Cost Performance Categories

Posted by Lauren Patrick on January 4, 2019

As laid out in the 2019 MACRA final rule*, one of the ways CMS hopes to expand participation options in the program’s third year is by offering certain facility-based clinicians, if they participate as a group, the option to use facility-based Quality and Cost performance measures. CMS expects to release a facility-based scoring preview for this option, which does not require any data submission, in Q1 of 2019. In today’s blog, we’ll take an in-depth look at the details of facility-based scoring and how it will be applied.

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Topics: MACRA & MIPS, Policy, Quality Performance Category, Cost Performance Category

Improvement Provision for Quality and Cost Measures

Posted by Lauren Patrick on February 22, 2018

In year two of MIPS and beyond, CMS is including an Improvement score for Quality and Cost measures. This week we take a deep dive into what this score entails, as well as what you need to know to keep yours ahead of the curve.

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Topics: MACRA & MIPS, Policy, Quality Performance Category, Cost Performance Category

MIPS Performance Categories in 2018

Posted by Christina Zink on November 3, 2017

With the first performance year of the Merit-based Incentive Payment System (MIPS) drawing to a close, you may have just started getting accustomed to how MIPS reporting works. Although the 2018 MACRA final rule introduced changes to how MIPS performance data should be captured for the upcoming performance year, it may be a relief to hear that largely the changes just build upon the existing 2017 regulations.

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Topics: MACRA & MIPS, Policy, Quality Performance Category, ACI Performance Category, IA Performance Category, Cost Performance Category

MIPS Performance Categories in the MACRA Final Rule

Posted by Christina Zink on October 14, 2016

Today, the Department of Health and Human Services (HHS) released the final rule with comment period for the Quality Payment Program under MACRA. Consistent with what was discussed in the proposed rule, the MACRA Quality Payment Program will have two tracks: (1) Advanced Alternative Payment Models (APMs) and the Merit-Based Incentive Payment System (MIPS). 

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Topics: MACRA & MIPS, Policy, Quality Performance Category, ACI Performance Category, IA Performance Category, Cost Performance Category

The Four Performance Categories of MIPS: PQRS in Sheep's Clothing

Posted by Lauren Patrick on August 4, 2016

As a young adult from a small town in Ohio, the prospect of leaving my hometown to go to college was a frightening one. I was anxious to leave the familiarity of my high school, and the routine I had perfected to remain an A student. The only expectation that I had was given to me by my teachers, who reported that college would be significantly different and more challenging than high school. As I packed up my ‘63 International Scout to drive to college in August of 1975, the fear of failure was present and strong. However, when I arrived, I found the classes were similar, the pedagogical approach was the same, and as long as I showed up and did the work, I could do as well as I did in high school.

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Topics: PQRS, MACRA & MIPS, Policy, Quality Performance Category, ACI Performance Category, IA Performance Category, Cost Performance Category