Healthmonix Advisor

Living squarely in Eagles territory with the big game less than a week away, I've noticed several correlations between the journey to becoming a winning football team and the implementation of a winning value-based care strategy.  A successful transition to VBC requires time, deliberation, and dedication to improving quality outcomes.  Sharing a vision isn't enough. There must be a greater commitment by the whole team to do what is necessary to achieve greatness.  Nothing good ever comes easily, so the key to winning is to keep your eye on the prize.  Here are just a few pro-tips for paving your way to victory:

Hospital readmissions can be bad news for patients, but they can also be bad news for a hospital’s bottom line. Readmissions cost $41.3 billion overall, a majority of which—about $26 billion annually—is paid by Medicare. Moreover, as much as $17 billion of Medicare-paid readmissions are considered to be avoidable.

But why would they care? If a clinician moves to a new practice, wouldn’t they receive the score, and adjustment, for that new practice? Unfortunately for clinicians looking to start fresh, the answer is no.

Depending on your performance and your desire to maximize your reimbursement in 2019 (who doesn’t want more revenue?), there are a number of options available in final submission of your MIPS data to CMS. All of these choices can seem overwhelming, but Healthmonix is here to help! Read on to find out what choices you'll face and how to make the best ones for your practice.

Considering that the CMS Quality Payment Program can generate payment adjustments of up to 22% of Medicare Part B FFS reimbursements, it’s no wonder that many providers and health systems hope to maximize these incentives. But navigating complex Medicare requirements can be near impossible without the right tools.

Statistically, you aren’t sure how you’re supposed to comply with quality reporting requirements this year. As late as June 2017, the majority of providers were still unfamiliar or only somewhat familiar with MACRA; only 9 percent described themselves as “very familiar”. But unless you’re a part of that 9 percent, we highly recommend that you take some time ASAP to familiarize yourself with the requirements and to make a plan for the rest of the year. And as part of that plan, here are four reasons why we recommend that you select Improvement Activities for your practice today (yes, literally today):

When we asked MIPS eligible clinicians about their experiences transitioning from PQRS this year, one of the biggest takeaways was that quality matters even more under MIPS than it did under PQRS. Clinicians who want to maximize their reimbursement would consequently be very smart to start reporting as early as possible, and to adjust performance to maximize quality, rather than waiting until the end of the year. If you’re not sure whether or not you are a MIPS-eligible clinician, take advantage of one of the following resources for determining your MIPS participation status as soon as possible so that you don’t get left behind.

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.

Maybe you’ve reported PQRS in the past and are already preparing to make the transition to MIPS this year. Or, maybe this year is the first time your practice plans to report. Either way, your method of reporting can help determine whether or not you achieve your quality and revenue goals, and the benefits and drawbacks of different methods must be weighed in relation to the unique needs of your practice. To give you a place to start, this post compares and contrasts some considerations related to two common submission mechanisms: EHR and Qualified MIPS Registry reporting.