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New Reality of Medicare Physician Payments, Future with MIPS
- The Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) was enacted by Congress to address issues related to physician payments under Medicare. The primary goal of MACRA was to move away from the traditional fee-for-service payment model and towards a value-based payment system. MACRA introduced the Quality Payment Program (QPP), which...
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Regulatory Burdens in Healthcare Take Away from Patient Care
Regulatory burdens in healthcare, such as prior authorizations, surprise billing requirements, and audits and appeals, are taking resources away from patient care as practices face more...Sponsored by Brault
MIPS Value Pathways: Pros and Cons for Emergency Medicine Physicians
A new option under CMS' Merit-Based Payment Incentive System (MIPS) aims to streamline reporting requirements and align quality measures with specific specialties. However, emergency physicians and...Study Finds MIPS Scores Don’t Reflect True Quality Performance
A recent study out of the Weill Cornell Medical College questions whether the Merit-Based Incentive Payment System (MIPS) accurately captures the quality of care delivered by primary care...Healthcare Orgs Urge Congress to Improve Value-Based Care Participation
Healthcare groups have called on Congress to extend incentive payments, revise threshold requirements, and expand regulatory waivers to address concerns about the Medicare Access and CHIP...CMS Nixes MIPS Facility-Based Scoring for 2022 Performance Year
Facility-based scoring in the Merit-Based Incentive Payment System (MIPS) will not be available for the 2022 performance year after recent changes to the Hospital Value-Based Purchasing (VBP) Program,...CMS Proposes Quality Payment Program Updates in CY23 PFS Rule
In its recently released calendar year (CY) 2023 Medicare Physician Fee Schedule (PFS) proposed rule, CMS proposed Quality Payment Program (QPP) changes to the Merit-based Incentive Payment System...Breaking Down Common CMS Value-Based Payment Programs
Value-based payment programs tie healthcare reimbursement rates to quality care by offering providers incentive payments to meet specified quality measures during and after healthcare delivery. As the industry moves away from...Why Rural Providers Aren’t Transitioning to Alternative Payment Models
A smaller percentage of providers in rural or health professional shortage areas eligible to participate in Advanced Alternative Payment Models (APMs) did partake in the Quality Payment Program track compared to providers not located in...Prior Authorizations Beat COVID Workplace as Top Regulatory Burden
Prior authorizations are troubling medical groups more than regulations governing the workplace during COVID-19 and Medicare’s Quality Payment Program, according to survey results from the...Sponsored by Brault
Escalating Risk, Reward of the Merit-Based Incentive Payment System
MIPS is a sub-program under the CMS Quality Payment Program (QPP), which is designed to support the transition from fee-for-service federal payments into value or quality-based payments. The program...Most Group Practices Received Positive MIPS Scores For 2020 Payments
The majority of group practices that participated in Medicare’s Merit-Based Incentive Program System (MIPS) in 2018 received exceptional or positive performance scores for 2020 payment...MIPS Quality Score Not Often Associated with Better Patient Outcomes
Better Merit-based Incentive Payment System (MIPS) quality scores were rarely associated with lower rates of hospital complications during the first year of program implementation, according to a study...Key Quality Payment Program Changes in 2022 PFS Proposed Rule
If finalized, the Quality Payment Program (QPP) will undergo significant policy changes under the Medicare Physician Fee Schedule (PFS) proposed rule. Most notably, the rule introduced the first seven...What Drives Value in the Merit-Based Incentive Payment System?
In a recent survey, physicians were asked if and how the four evaluation components of the Merit-based Incentive Payment System (MIPS)—quality, promoting interoperability, improvement...CMS: Automatic Exception for MIPS Eligible Clinicians in 2020
Individual clinicians who must participate in Medicare’s Merit-Based Incentive Payment System (MIPS) for the 2020 performance period will automatically have the extreme and uncontrollable...Deadline to Provide Billing Info for Advance APM Bonus Approaches
UPDATE 11/20/2020: CMS has extended the deadline to update billing information for APM incentive payments to December 13, 2020. Eligible clinicians who CMS has notified as having missing billing...CMS Releases Initial Quality Payment Program Results for 2019
Eligible clinicians overwhelmingly participated in the Quality Payment Program despite facing challenges caused by the COVID-19 pandemic, according to preliminary data from CMS. CMS announced in a...Sponsored by Brault
