Healthmonix Advisor

Overcoming Challenges in Patient Matching and Deduplication  for ACO Quality Reporting

Posted by Lauren Patrick on September 28, 2023

ACOs have encountered challenges with aggregating, matching, and deduplicating extensive, disparate patient data required under the eCQM and MIPS CQM quality measure collection types. Patient matching and deduplication are needed to accurately calculate quality metrics from data across multiple practices and EHR instances.  

Read on as we unravel the challenges and several methods to overcome these challenges. 

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Topics: MACRA & MIPS, MIPS CQMs, MIPS Reporting

The MIPS Cost category’s impact on orthopedic groups

Posted by Lauren Patrick on September 14, 2023

In the ever-evolving healthcare world, staying current is vital. Orthopedic surgery, particularly arthroplasty, has been at the forefront of the shift toward value-based care models. With certain procedures already subject to bundled payments for over a decade, the integration of cost measures within the Merit-Based Incentive Payment System (MIPS) is a game-changer.

Read on as we unravel the vital details of this essential aspect of modern healthcare performance assessment.

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Topics: MACRA & MIPS, MIPS CQMs, MIPS Reporting

Hospitals are seeing the impact of the MIPS Cost Category for 2024 reimbursements.

Posted by Lauren Patrick on September 7, 2023

With 2022 MIPS final scores available, hospitals and health systems have seen the Cost category produce a major impact on their overall MIPS scores.  

Before CMS added the Cost category to 2022 MIPS scores, hospitals had little insight into how it would impact MIPS scores. With scores out, we see that many hospitals and health systems were scored on over 10 Cost category measures. That’s a large amount of data to sift through and analyze.

 

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Topics: MACRA & MIPS, MIPS CQMs, MIPS Reporting

CMS releases final 2022 MIPS performance scores and 2024 incentives

Posted by Savannah Vasquez on August 24, 2023

Are you ready to jump back into the MIPS program?   

The Centers for Medicare & Medicaid Services (CMS) have released Final Performance Feedback for the 2022 Merit-based Incentive Payment System (MIPS) performance period. We are seeing record maximum incentives of 8.25% for providers who achieved top scores.   

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Topics: MACRA & MIPS, MIPS CQMs, MIPS Reporting

What is a Medicare CQM? The new proposed quality reporting option for MSSP participants.

Posted by Lauren Patrick on August 17, 2023

In the 2024 Proposed PFS Rule released in July 2023, CMS outlined a new option for MSSP participants to report quality measures called the Medicare CQM option. CMS created this reporting option to address concerns raised by ACOs and others, while still transitioning ACOs toward digital quality measure reporting. 

Read on to learn more about the new proposed option for MSSP participants. 

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Topics: MACRA & MIPS, MIPS CQMs, MIPS Reporting

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