Healthcare Revenue Cycle Management, ICD-10, Claims Reimbursement, Medicare, Medicaid

MACRA Implementation

PTAC Recommends 2 APMs for Potential MACRA Implementation

November 10, 2017 - The Physician-Focused Payment Model Technical Advisory Committee (PTAC) recently recommended two alternative payment models to HHS for possible MACRA implementation. Stakeholders have submitted 19 alternative payment model proposals since the committee launched after the 2015 MACRA implementation rule. The committee of 11 individuals with experience and expertise in physician-focused payment...


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The Pros and Cons of Quality Measure Choices In MACRA, MIPS

by Jacqueline Belliveau

Uprooting the fee-for-service payment system and changing the way clinicians provide care is no easy feat. With this in mind, CMS designed MACRA’s Merit-Based Incentive Payment System (MIPS) to gradually ramp up participation and offer...

Industry Orgs Concerned with 2018 MACRA Implementation Rule

by Jacqueline Belliveau

Industry groups, including the American Medical Group Association (AMGA) and the Medical Group Management Association (MGMA), are questioning if the new 2018 MACRA implementation rule truly promotes value-based care. In recent comments on the...

CMS Issues 2018 MACRA Implementation, Quality Payment Program Rule

by Jacqueline Belliveau

CMS recently issued a final 2018 MACRA implementation rule, detailing the requirements for Quality Payment Program participation in 2018. “CMS listened to feedback from the healthcare community and used it to inform policy making,”...

AMA Pres: Align MIPS Improvement Activities with APM Demands

by Jacqueline Belliveau

Providers can ensure their investments in the Merit-Based Incentive Payment System (MIPS) are worth it by engaging in Improvement Activities and other practice transformations that enhance overall Medicare performance and lead them to the alternative...

4 Strategies for Merit-Based Incentive Payment System Success

by Jacqueline Belliveau

Medicare providers who qualify to participate in MACRA’s Merit-Based Incentive Payment System (MIPS) face up to a 4 percent incentive payment or penalty based on their performance in 2017. Despite MIPS putting revenue at risk, many providers...

Using EHR Systems, Supports to Aid MIPS Reporting, Boost Scores

by Jacqueline Belliveau

Delivering high-quality care is already a complicated process for healthcare providers. Understanding, as well as reporting, to MACRA’s Merit-Based Incentive Payment System (MIPS) has made the task even more complex, explained Brad J. Abrams,...

100+ Medical Orgs Want MACRA Implementation Flexibilities Extended

by Jacqueline Belliveau

Over 100 medical organizations recently called on House Representatives to extend MACRA implementation flexibilities that allow HHS leaders to gradually implement full program requirements. The flexibilities should go on for another three years....

Specialists Face 16% MIPS Payment Adjustment Swing Under Proposal

by Jacqueline Belliveau

Specialists could face up to a 16 percent value-based incentive payment or penalty under MACRA’s Merit-Based Incentive Payment System (MIPS) in 2018 if a proposed rule to include Medicare reimbursement for Part B drugs in the program is...

AHA Supports Bundled Payment Cancellation, Voices MACRA Concerns

by Kyle Murphy, PhD

Despite back the decision by CMS to cancel two bundled payment models and modify another, the American Hospital Association contends that the federal agency is moving a bit too quickly in shifting providers to value-based payment. According to...

MedPAC Calls for MIPS Repeal, Voluntary Program Replacement

by Jacqueline Belliveau

The Affordable Care Act isn’t the only health policy facing a call for repeal and replace. The Medicare Payment Advisory Commission (MedPAC) recently urged HHS to repeal MACRA’s Merit-Based Incentive Payment System (MIPS) and replace...

MIPS Quality Reporting Flexibilities Trouble Providers, EHR Vendors

by Jacqueline Belliveau

It’s good to have options when it comes to the clothes we wear, cars we drive, and things we do. But having too many options when it comes to quality reporting under MACRA’s Merit-Based Incentive Payment System (MIPS) may prove to...

Specialists Lack Medicare Alternative Payment Model, MACRA Options

by Jacqueline Belliveau

Opportunities for specialists to join a Medicare alternative payment model are severely limited, especially for emergency medicine providers and audiologists, a recent Leavitt Partners report showed. As part of its effort to reimburse one-half...

Few Specialists Prepared for MACRA Implementation, MIPS Reporting

by Jacqueline Belliveau

All 800 specialty physicians surveyed in June by Integra Connect stated that they have yet to fully comprehend MACRA, resulting in few specialists investing in the capabilities needed for MACRA implementation. While 100 percent of the specialists...

AMGA: MIPS Exclusion Rules Inhibit Value-Based Care Under MACRA

by Jacqueline Belliveau

The American Medical Group Association (AMGA) recently opposed several proposed changes to the Quality Payment Program and its Merit-Based Incentive Payment System (MIPS) for the 2018 performance period. The group particularly expressed concerns...

CMS May Cancel Upcoming Cardiac, Ortho Bundled Payment Models

by Jacqueline Belliveau

UPDATE: CMS released the complete proposed rule, which would cancel the Episode Payment Models and the Cardiac Rehabilitation Incentive Payment Model. The proposed rule would also decrease the number of mandatory geographic regions in the Comprehensive...

Quality Payment Program, MIPS Top 2017 Regulatory Burden List

by Jacqueline Belliveau

Medicare’s new value-based reimbursement program has topped the list of most burdensome regulations for healthcare providers, according to a new MGMA survey. About 82 percent of leaders from 750 group practices viewed MACRA’s Quality...

Physician Expert, Clinical Documentation Key to MIPS Success

by Jacqueline Belliveau

Since the Obama administration signed MACRA into law in 2015, healthcare providers have been attempting to understand the Quality Payment Program and its Merit-Based Incentive Payment System (MIPS). But regular updates and tweaks to MACRA have...

3 Pain Points Affecting Small Practice Healthcare Revenue Cycle

by Jacqueline Belliveau

While working in a small practice allows providers to really understand their patients and their community’s healthcare needs, it can also create unique healthcare revenue cycle management challenges. Small practices come with several advantages....

Surveys Reveal MACRA Implementation, QPP Knowledge Lacking

by Jacqueline Belliveau

Two recent surveys indicated that healthcare provider and executive knowledge of and readiness for MACRA implementation and the Quality Payment Program are lacking despite the value-based reimbursement program launching in January 2017. A new...

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