As of January 1, 2017, the first performance period for the new Merit-based Incentive Payment System (MIPS) is officially underway for eligible physicians. The new payment system aims to change how physician services are paid by moving away from fee-for-service payments to performance-based payment adjustments. Depending on the data you submit by March 31, 2018, your 2019 Medicare payments could be adjusted up, down, or not at all.
Payer contracts represent a significant amount of physician revenue and should be evaluated with careful scrutiny. Physicians who fail to negotiate with payers or gain a clear understanding of insurance contracts risk presenting a financial blow to their medical practice.
The Centers for Medicare & Medicaid Services (CMS) and the National Library of Medicine (NLM) has published an addendum to the 2016 eCQM specifications (published in April 2016). This addendum updates relevant International Classification of Diseases (ICD)-10 Clinical Modification (CM) and Procedure Coding System (PCS) eCQM value sets for the 2017 performance year.
Worried about participating in the Merit-based Incentive Payment System? CMS is conducting a Clinical Practice Improvement Activities (CPIA) Study that can help you meet the CPIA requirement. Individual clinicians and groups who are eligible for MIPS that participate successfully in the study will receive full credit for the Improvement Activities performance category. Applications for the study will be accepted from January 1 – 31, 2017.
When it comes to government regulations and health care, change is inevitable. In contrast to the current fee-for-service care, the value-based care model aims to compensate physicians for high-quality service, clinical performance, and patient satisfaction. It's an exciting time for the future of healthcare, and small practices are uniquely situated to thrive in the transition to value-based care.
What a year it has been! Thank you to all of our readers for your continued support and readership. This year, our blog subscribers doubled and we celebrated 25 years of helping practices overcome some of the most difficult healthcare reimbursement challenges. We're looking forward to another great year and will continue to publish helpful content that helps your practice succeed in a rapidly changing healthcare reimbursement environment. But before we head into 2017, let's take a look back at some of our most popular posts from 2016.
With 2017 upon us, many practices are scrambling to understand the Quality Payment Program final rule. The final rule was published on October 14, 2016 with CMS making significant revisions to the proposed rule. In the final rule, CMS increased the flexibility of the Medicare Access and CHIP Reauthorization Act (MACRA) by introducing an option-based implementation plan, titled “Pick Your Pace,” which allows providers to ease into MACRA for the 2017 reporting year.
The Centers for Medicare and Medicaid Services (CMS) has recently released new quality data on the Physician Compare website, which includes 2015 Physician Quality Reporting System (PQRS) performance scores for group practices, individual physicians and other clinicians, and Accountable Care Organizations (ACOs), as well as non-PQRS Qualified Clinical Data Registry (QCDR) data for individual clinicians. Here's what this means to your practice.
2017 is just around the corner and with it comes a number of new CPT codes, deleted codes, and code revisions. The updates made enable providers to get paid for some work that is already being done while other updates remove barriers to providing certain services such as Chronic Care Management.
Earlier this week, President Barack Obama signed the 21st Century Cures Act into law. The Cures Act invests in President Obama's priorities in Science and Health by providing funding for various projects such as the Precision Medicine Initiative and Cancer Moonshot while targeting better EHR use and supporting health data interoperability.
Although healthcare facilities of all sizes and types are required to choose a HIPAA compliance officer to make sure that regulations are followed, some choose to blend the role with an existing one. For small to medium-sized practices, the thought of hiring a full-time HIPAA compliance officer may seem financially unfeasible.
A recent Medscape study found that self-employed physicians are more satisfied in their profession than employed physicians (63% vs 55%). However, the Employed Doctors Report 20161 states that twice as many doctors (27% vs. 13%) have switched from independent practice to employed. But why?
Most EHR systems have fallen short of physician expectations over the years. System functionality, cost, and poor customer service have all contributed to a growing number of practices switching or replacing their EHR software. When practices are considering switching to a new EHR, data migration is a common question. Here I'll cover some helpful data migration tips to help your practice during the transition to a new EHR.
With HIPAA violation fines reaching up to $50,000 per occurrence and a maximum annual penalty of $1.5 million per violation, it's important for medical practices to ensure they are HIPAA compliant at all times. And while all possible HIPAA violations should be considered potential threats to your medical practice, some are more common than others.
More than ever before, physicians are facing an abundant amount of challenges. Declining reimbursement, changing payment models, and uncertainties surrounding new administration and the Affordable Care Act just to name a few. While the coming year presents many challenges to physicians, we’ve identified six of the top challenges most common among physicians that can also be less intimidating through further education and, of course, much preparation.
Topics: Revenue Cycle Management
It's no secret that the relationship between health care providers and insurance companies is complicated. Healthcare providers are spending a significant amount of time and energy with patients just to find out that an insurance company will fight them on paying for the services provided. Preventing claim denials helps ease the complications but denial management doesn't come so easy to every medical practice.
Wondering what it takes for your medical practice to reach true financial success? Two words: data collection. A top performing medical practice can be defined as one that achieves profitability, month after month. Not only to pay the bills but to invest in the right people, proper clinical tools and business assets to maintain their financial success. Here's what these practices know about analytics that you possibly do not.
Topics: Revenue Cycle Management
This year's Physicians Practice Physician Compensation survey revealed some interesting insights into the financial burdens physicians are experiencing. The survey not only gathered insight into things like overhead costs and personal income but also touched on how practices have been affected by high-deductible insurance plans.
The final rule on MACRA was released by the Department of Health and Human Services on October 14th, 2016. Since the final rule weighs in at a staggering 2,171 pages, we here at GroupOne thought it would be helpful to provide you with a list of resources that offer detailed information about the final rule.