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Insights to guide your practice. 

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What You Need to Know Now: Analyzing the 2018 MACRA Quality Payment Program Final Rule

by Kaitlyn Houseman on November 3, 2017

Yesterday the Centers for Medicare & Medicaid Services (CMS) issued the final rule with comment for the second year of the Quality Payment Program (calendar year 2018) as required by the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA). The changes reflect the commitment CMS has made to minimizing the burden of participation in the Quality Payment Programs while still focusing on meaningful measurement and improved healthcare delivery.

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Topics: Revenue Cycle Management, Merit Based Incentive Payment System, MACRA, Alternative Payment Models

5 MIPS Myths Debunked!

by Kaitlyn Houseman on September 8, 2017

 As we near October 2nd, the last day to start participating in MIPS and satisfy the 90-day minimum performance period, it's important to separate fact from fiction. According to CMS, nearly 600,000 clinicians will participate in MIPS under the Quality Payment Program but there's still some confusion surrounding participation options, eligibility, and the program in general. Here we'll clear up some common misconceptions about the MIPS program to help you better understand what MIPS is and how it affects your practice.

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Topics: Revenue Cycle Management, Merit Based Incentive Payment System, MACRA, Alternative Payment Models

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

CMS Comprehensive Primary Care Plus Initiative FAQs

by Jeff Jones, CPHP on September 7, 2016

In April we published a post announcing the launch of the new risk-based primary care initiative, Comprehensive Primary Care Plus (CPC+). Now, we are nearly just one week away from applications for CPC+ being due. So what should you know before submitting your application? We've compiled a list of frequently asked questions about the CPC+ program and some answers to help you better understand it.

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Topics: Alternative Payment Models

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

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