Healthmonix Advisor

Will 2021 MIPS Finally Bring Significant Financial ROI for Providers?

Posted by Matthew Major on November 24, 2020

Clinicians participating in the Merit-Based Incentive Payment System (MIPS) are set to finally receive a worthwhile financial return for 2021 reporting. Providers have been unsure whether incentive returns of less than 2% justifies shifting focus to achieve a high score in the program. A provider collecting $400,000 in Medicare Part B payments in 2020 will only receive $6,700 for scoring well in 2018 quality payment program (QPP) performance. While this does produce a positive return on investment, it may cause practices to question whether it is worth the effort required to track and report measures.

Read More

Topics: MACRA & MIPS, Policy

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.

Read More

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

Key Takeaways on the 2021 Proposed Rule

Posted by Mike Lewis on August 14, 2020

The 2021 Proposed Rule was released last week, and there are some potential changes that you should keep your eye on. Scouring through the entire release, it’s apparent that the Centers for Medicare & Medicaid Services (CMS) kept to their two main objectives:

  1. Minimize changes to reduce the burden on providers digging out of COVID-19
  2. Keep the momentum of the Quality Payment program moving forward
Read More

Topics: MACRA & MIPS, CMS, Policy, 2021 PFS Proposed Rule

2020 MIPS Reporting Period – Did it Get Cut in Half?

Posted by Lauren Patrick on July 30, 2020

The quick answer is NO!

There has been quite a bit of discussion, and some press, about the reporting period for MIPS for 2020. I have seen a few articles saying that no data reflecting services provided January 1, 2020 through June 30, 2020 will be used in the Center for Medicare & Medicaid Services (CMS’s) calculations for the Medicare quality reporting and value-based purchasing programs. However, if you read the Quality Payment Program – COVID-19 Response, Updated 6/24/2020, there is no mention of an all-inclusive change to the reporting period.

Read More

Topics: MACRA & MIPS, CMS, Industry insights

No CMS Updates on COVID-19's Impact on MIPS reporting - What it means

Posted by Robert Stoudt on June 18, 2020

In the last couple of weeks, some major changes have been made to the immediate future of Value-Based Care payment models.

Some of these updates include:

  • The extension of the Oncology Care Model (OCM) until June of 2022. The Centers for Medicare & Medicaid Services (CMS) is also giving practices the ability to abdicate downside and upside risk performance during the COVID-19 outbreak.
  • The delay of starting the new Direct Contracting model to April 1st, 2021.
  • The extension of the Next-Gen ACO model until December 2021.
  • The option for participating entities in the Bundled Payments for Care Improvement Advanced (BPCI) payment model  to eliminate upside or downside risk.
  • The removal of COVID-19 episodes of care for certain Medicare ACO models.
Read More

Topics: MACRA & MIPS, CMS, COVID-19

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.

Read More

Topics: MACRA & MIPS, Cost Performance Category

How will the QPP MIPS program be affected by the COVID-19 pandemic?

Posted by Lauren Patrick on May 18, 2020

We know the current regulatory updates for the Quality Payment Program (QPP) program. To date,  the Centers for Medicare & Medicaid Services (CMS) has issued many changes. The 2019 MIPS reporting requirement had an extended deadline and options for hardship exemptions. The 2020 MSSP program reporting period had many changes in both of the interim final rule with comment periods (IFCs) issued by  CMS, at the end of March and the end of April. CMS has also added a COVID-19 improvement activity to the 2020 program, that provides full credit for the Improvement Activity category for MIPS, if an individual or 50% of a group (TIN) participates in clinical trial reporting. No changes to the reporting window or other parameters of the program have been issued.

Read More

Topics: MACRA & MIPS, COVID-19

Quality Payment Program COVID-19 Response - Update April 6

Posted by Lauren Patrick on April 6, 2020

The Centers for Medicare & Medicaid (CMS) is working rapidly to update policies and allow healthcare providers to flexibly apply best practices in response to the COVID-19 pandemic.  Programs such as Hospitals without Walls and the existing Patients over Paperwork have been deployed.  Removal of barriers have resulted in exponential growth of telehealth and remote patient monitoring.   Advanced payments to healthcare providers are being provided to counter the effects of changing patterns of healthcare use,  reduction in elective procedure, increase in ICU utilization and other ongoing unanticipated changes.

Read More

Topics: MACRA & MIPS, Quality Performance Category, COVID-19, submission

The CARES Act - March 27, 2020

Posted by Lauren Patrick on March 29, 2020

There is a tsunami of information coming at us all about COVID-19, the impact to healthcare practices, the business climate, and the federal government response. On Friday, we saw monumental legislative changes.  I haven't read the entire 887 page document yet, but here are a couple of the best recaps I've seen.  

Read More

Topics: MACRA & MIPS, COVID-19

Why MIPS 2020 Will Be More Difficult Than Keeping a New Year’s Resolution

Posted by Joy Rios of Chirpy Bird Health IT Consulting on January 23, 2020
Read More

Topics: PRO Tips, MACRA & MIPS, Policy, Healthmonix, Eligibility