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GroupOne Health Source Practice Management Blog

      

The GroupOne Health Source Blog

 Answers and Insights Every Healthcare Professional Needs.

 

A Cheat Sheet to the Merit-Based Incentive Payment System [Infographic]

by Jeff Jones, CPHP on February 17, 2017

Are you eligible for MIPS? With 2017 being the first performance year, it's imperative that you know how the Merit-based Incentive Payment System could affect your revenue cycle management.  We put together a cheat sheet to help you understand your participation options with MIPS in 2017 and the financial impact it could have on your revenue cycle in the coming years.

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Topics: Merit Based Incentive Payment System, Incentive Programs, MACRA

Important Upcoming CMS Deadlines

by Kaitlyn Houseman on February 16, 2017

CMS has extended the attestation deadline for providers participating in the Medicare EHR Incentive Program to Monday, March 13, 2017, at 11:59 p.m. PT. As a quick reminder, if you received a letter from CMS that said you are subject to the 2017 Medicare EHR payment adjustment and you believe this payment adjustment is in error, you must submit a reconsideration application for the 2017 payment adjustment by February 28, 2017. Here are more details and resources on both of these upcoming deadlines.

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Topics: CMS, Incentive Programs

CMS Extends Meaningful Use Attestation Deadline

by Kaitlyn Houseman on February 9, 2017

The Centers for Medicare & Medicaid Services (CMS) has extended the attestation deadline for providers participating in the Medicare EHR Incentive Program to Monday, March 13, 2017, at 11:59 p.m. PTProviders participating in the Medicare EHR Incentive Program must attest to the 2016 program requirements by March 13, 2017 to avoid a 2018 payment adjustment. 

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Topics: CMS, Incentive Programs

Medicare EHR Incentive Program Registration and Attestation System Now Open

by Kaitlyn Houseman on January 18, 2017

The Centers for Medicare & Medicaid Services Registration and Attestation System is now open. Providers participating in the Medicare EHR Incentive Program must attest to the 2016 program requirements by February 28, 2017 at 11:59 p.m. ET in order to avoid a 2018 payment adjustment.
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Topics: CMS, Incentive Programs

President Obama Signs 21st Century Cures Act into Law

by Kaitlyn Houseman on December 15, 2016

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.

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Topics: Interoperability, Incentive Programs, Healthcare Policy

HHS Finalizes Medicare Payment System-MACRA Final Rule Released

by Jeff Jones, CPHP on October 18, 2016

The Department of Health & Human Services (HHS) finalized a landmark new payment system for Medicare clinicians that will continue the Administration’s progress in reforming how the health care system pays for care. The Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) Quality Payment Program, which replaces the flawed Sustainable Growth Rate (SGR), will equip clinicians with the tools and flexibility to provide high-quality, patient-centered care.

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Topics: Merit Based Incentive Payment System, Incentive Programs, MACRA, Alternative Payment Models

An Explanation of the Merit-Based Incentive Payment System (MIPS)

by Jeff Jones, CPHP on October 13, 2016

The Merit-based Incentive Payment System (MIPS) is coming in 2019, and this new physician payment policy is undoubtedly going to be a game-changer. Although it's still a few years out, it's important for healthcare professionals to develop a thorough understanding of how the Merit Based Incentive Payment System and MACRA in general will impact physician reimbursement and medical practice operations.

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Topics: Merit Based Incentive Payment System, Incentive Programs, MACRA

Four New MACRA Tracks Allow Flexible Attestation for Providers

by Jeff Jones, CPHP on September 12, 2016

On September 8th, Acting Administrator of CMS Andy Slavitt announced four MACRA implementation tracks that will allow eligible clinicians to pace their own transition and participation in the program. Eligible clinicians will be able to select their own pace for MACRA attestation to ensure all participants can succeed under new value-based reimbursement programs, CMS announced.

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Topics: Merit Based Incentive Payment System, Incentive Programs, MACRA

Meaningful Use Update: Keeping Your Practice on Track for 2016

by Jeff Jones, CPHP on September 6, 2016

We welcomed the news earlier this year that the Centers for Medicare & Medicaid Services (CMS) and the Office of the National Coordinator for Health Information Technology (ONC) released a Notice of Proposed Rulemaking (NPRM) to allow for flexibility in meeting Meaningful Use this year. However, the 90-day reporting period for 2016 still has not been finalized and the final 90-day reporting period in calendar year 2016 is rapidly approaching.

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Topics: Incentive Programs

The Impact of MACRA on Your Practice

by Jeff Jones, CPHP on July 28, 2016

Encouraging physicians to switch to electronic health records (EHR) has been a long term effort from CMS ever since the January 2009 passage of the HITECH act. Over three-quarters of physicians and nearly all hospitals are using an EHR but the incentivizing structure has been hard to wade through, at best. Now healthcare professionals and physicians alike must focus their efforts on understanding the end of the SGR formula and the beginning of The Merit Based Incentive Payment System and Alternative Payment Models.

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Topics: Revenue Cycle Management, Incentive Programs, MACRA

Are You Exempt from MIPS? How Advanced APMs Differ From APMs

by Jeff Jones, CPHP on June 15, 2016

Some interesting discussions have emerged since the MACRA proposed rule was announced. One that is acquiring a lot of attention is the eligibility requirements of Advanced APM entities. Under the proposed rule only Advanced APMs will qualify for the 5% annual lump sum payment and be exempt from MIPS. In this post we will dive deeper into what it takes to become an Advanced APM and what happens if an APM entity does not qualify as an Advanced APM.

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Topics: Revenue Cycle Management, Merit Based Incentive Payment System, Incentive Programs

What is an Advanced Alternative Payment Model?

by Jeff Jones, CPHP on June 7, 2016

The MACRA final rule details how Alternative Payment Models (APM) will enhance or replace some of the current fee-for-service payments. While the criterion may seem simple in theory, additional details help clarigy the difference between an Advanced Alternative Payment Model and an Alternative Payment Model.

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Topics: Revenue Cycle Management, CMS, Incentive Programs, MACRA

MACRA: New Opportunites for Medicare Providers with Alternative Payment Models

by Jeff Jones, CPHP on May 26, 2016

With the repeal of Medicare's sustainable growth rate formula also came the opportunity for physicians to eventually leave the traditional Medicare fee-for-service system behind. The shift from fee-for-service to value based reimbursement is a new opportunity for physicians but with it comes some challenges in understanding how it will work. The final rule, released on Oct. 14th, details how Alternative Payment Models (APM) will enhance or replace some of the current fee-for-service payments with a patient-level payment not related to volume or intensity.

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Topics: Value-Based Reimbursement, Incentive Programs, MACRA, Alternative Payment Models

What You Need to Know About the MACRA NPRM

by Jeff Jones, CPHP on May 25, 2016

The Centers for Medicare and Medicaid have released the notice of proposed rule-making (NPRM) for the Medicare Access and CHIP Reauthorization Act. The proposed rule was released in late April and the final rule is schedule to be released in the fall of this year (2016). Here is a breakdown of the MACRA NPRM if you haven't yet had the time to read the entire 962 pages.

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Topics: Revenue Cycle Management, CMS, Merit Based Incentive Payment System, Incentive Programs

A Simple Guide to Understanding PQRS Measures and Specifications

by Jeff Jones, CPHP on May 19, 2016

In 2016, providers are able to select from a large number of measures to submit PQRS data. However, understanding PQRS measures and specifications can be overwhelming. And since the measures you choose have a large impact on your quality and cost scores, deciding on the right measures to report should not be taken lightly. Here we will guide you through how to better understand PQRS measures and the specifications for measures.

 

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Topics: PQRS, Incentive Programs

The Value-Based Payment Modifier Program and It's Impact on Your Practice

by Jeff Jones, CPHP on May 4, 2016

The Value-based Modifier (VBM) provides for differential payments to a physician or group of physicians under the Medicare Physician Fee Schedule and is based upon the quality of care furnished compared to cost during a performance period. The Value Modifier program will provide comparative performance information to physicians as part of Medicare’s effort to improve the quality and efficiency of medical care. Here is how the Value Modifier program relates to PQRS and MIPS to further the movement from fee-for-service to value-based reimbursement.

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Topics: PQRS, Value-Based Reimbursement, Incentive Programs

Selecting the Right PQRS Measures: Individual vs. Measures Groups

by Jeff Jones, CPHP on May 2, 2016

Taking time to select the right PQRS measures can make a huge difference in an Eligible Providers (EP) performance in PQRS. How? Because choosing PQRS measures that align with your specialty usually makes it easier to report for the PQRS. Therefore the measure selection process should begin with a review of the entire measure list to determine which measures are important to the EP and the practice.

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Topics: PQRS, Incentive Programs

Everything You Need to Know About PQRS Reporting Methods

by Jeff Jones, CPHP on April 15, 2016

As we shift the focus from volume and profitability to patient outcomes, physicians are having to dig a litter deeper into reporting. Healthcare is shifting towards value-based reimbursement models and the Physician Quality Reporting System (PQRS) is a step in that direction. Unfortunately, at first glance, PQRS and CQM programs can be intimidating to say the least. Not only can PQRS be intimidating, but a large number of physicians believe that PQRS is time-consuming. PQRS participation rates reflect the number of providers that aren't making PQRS a priority. 

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Topics: PQRS, Incentive Programs

Understanding PQRS: What It Is and What You Need to Know Now

by Jeff Jones, CPHP on April 12, 2016

You could say Meaningful Use stole the spotlight from PQRS over the past couple of years. This could be why so many providers still have questions about the Physician Quality Reporting System. With the Merit Based Incentive Payment System (MIPS) just around the corner, PQRS isn't quite in the spotlight but it does play an important role in physician reimbursement. Now is the time to begin understanding PQRS (if you don't already) and how it will contribute to MIPS.

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Topics: PQRS, Incentive Programs

CMS Launches Comprehensive Primary Care Plus: Value-Based Model for Primary Care Practices, Multiple Insurers

by Kaitlyn Houseman on April 11, 2016

The Centers for Medicare and Medicaid Services on Monday launched a new risk-based primary care initiative that it hopes will accelerate the movement towards value-based reimbursement for medical practices. The five-year, Comprehensive Primary Care Plus, or CPC+, starts in January 2017 and will include up to 5,000 practices and 20,000 physicians in an estimated 20 regions.

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Topics: Value-Based Reimbursement, Incentive Programs