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Insights to guide your practice. 

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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

Should You Be Participating In PQRS?

by Jeff Jones, CPHP on March 29, 2016


For the first few years of PQRS, practices were eligible for incentive payments for PQRS reporting. In 2015, however, EPs that did not report on specific quality measures are facing downward adjustments to Medicare payments in 2017. Here's how you know whether you should be participating in PQRS (if you aren't already).
 

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Topics: PQRS, Incentive Programs

Medicare EHR Incentive Program Attestation Deadline this Friday

by Kaitlyn Houseman on March 9, 2016

Eligible professionals, eligible hospitals, and critical access hospitals (CAHs) participating in the Medicare Electronic Health Record (EHR) Incentive Program must attest using the Medicare & Medicaid EHR Incentive Program Registration and Attestation System no later than Friday, March 11, 2016 at 11:59 p.m. EST.

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Topics: CMS, Incentive Programs

CMS Extends Hardship Exception Application Deadline

by Kaitlyn Houseman on February 29, 2016

The Centers for Medicare & Medicaid (CMS) has extended the deadline to July 1 for eligible professionals (EPs), eligible hospitals (EHs), and critical access hospitals (CAHs) to apply for a Medicare Electronic Health (EHR) Incentive Program Hardship Exemption.

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Topics: CMS, Incentive Programs

Is Your Brand at Risk? How MIPS Can Impact Physician Brand

by Jeff Jones, CPHP on February 23, 2016

In our previous blog post, How MIPS Affects Physician Reimbursement, we introduced the topic of how MIPS will highlight a clinician’s brand and could possibly affect the amount of patients a clinician sees. This blog post dives deeper into this concept and explores what you can do to begin attacking MIPS now in order to establish a positive brand and start accepting new patients.

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Topics: Merit Based Incentive Payment System, Incentive Programs

6 FAQs About the Merit Based Incentive Payment System

by Jeff Jones, CPHP on February 18, 2016

In April 2015, both Congress and President Obama approved a bill called the Medicare Access and CHIP Reauthorization Act (MACRA), a significant, bipartisan bill that repealed the Medicare Part B SGR reimbursement formula and replaced it with a pay-per-performance program. This new program is called the Merit-Based Incentive Payment System (MIPS) and it is changing provider reimbursement.

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Topics: Merit Based Incentive Payment System, Incentive Programs

CMS Extends the Attestation Deadline for the EHR Incentive Programs

by Kaitlyn Houseman on February 11, 2016

The Centers for Medicare & Medicaid Services (CMS) extended the attestation deadline for the Medicare and Medicaid Electronic Health Record (EHR) Incentive Programs to Friday, March 11, 2016 at 11:59 p.m. ET, from the original deadline of Monday, February 29.

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Topics: CMS, Incentive Programs

How MIPS Affects Physician Reimbursement

by Jeff Jones, CPHP on February 9, 2016

Declining reimbursement is one of the greatest financial challenges physicians face today. While there isn't much you can do to stop reimbursement cuts, you can be proactive in learning about the Merit Based Incentive Payment System and how it will impact physician reimbursement.

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Topics: Merit Based Incentive Payment System, Incentive Programs

The Merit-Based Incentive Program: What You Need to Know

by Jeff Jones, CPHP on January 27, 2016

The healthcare industry has unveiled another addition to the already enormous alphabet soup. This new addition goes by the name MIPS, or more properly, Merit-based Incentive Payment System and it is quickly moving healthcare provider towards value-based reimbursement. Here's how.

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Topics: Merit Based Incentive Payment System, Incentive Programs

What the Meaningful Use Change Means for Your Practice

by Kaitlyn Houseman on January 22, 2016

While many physicians had a sigh of relief when CMS Acting Administrator Andy Slavitt announced last Monday that the end of the meaningful use program is near, many were left hanging with unanswered questions as to what is next. On Tuesday, CMS posted an update to Slavitt's comments that outlines the transition and what it means for doctors and hospitals.

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Topics: Incentive Programs

Obama Signs Meaningful Use Hardship Exemption Legislation

by Kaitlyn Houseman on January 5, 2016

Last week, President Obama signed into law a bill (S 2425) that expands providers' eligibility for hardship exemptions to Stage 2 of the meaningful use program, EHR Intelligence reports. The legislation will create a blanket hardship exemption from 2015 meaningful use penalties, which would have been assessed in 2017.

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Topics: CMS, Incentive Programs

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