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

MACRA Implementation

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

October 19, 2017 - 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, DO, FAAD, a dermatologist and Mohs surgeon. CMS designed MIPS to accelerate the value-based reimbursement transition. But many providers, especially...


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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...

Industry Orgs Back 2018 MACRA Implementation Flexibilities

by Jacqueline Belliveau

Healthcare industry organizations largely applauded the recently-released 2018 MACRA implementation proposal from CMS. The medical organizations commended the federal agency’s continuation of the transition year into 2018 as well as the...

CMS Proposes 2018 Quality Payment Program Changes

by Jacqueline Belliveau

CMS recently announced a proposed rule that would modify MACRA’s Quality Payment Program during its second performance year to ease provider burdens and continue to ramp up full participation in the program. A major proposed change would...

MedPAC Eyes Merit-Based Incentive Payment System Redesign

by Jacqueline Belliveau

The Medicare Payment Advisory Commission (MedPAC) recently advised Congress to redesign MACRA’s newly-launched Merit-Based Incentive Payment System (MIPS) by eliminating MIPS measures, replacing them with population health measures, and...

Count Medicare Advantage Patients for Advanced APMs, Orgs Say

by Jacqueline Belliveau

Eligible clinicians participating in appropriate alternative payment models under a Medicare Advantage plan should qualify for Advanced Alternative Payment Model (Advanced APM) incentive payments in 2019, the AMGA and nine other healthcare industry...

87% of Practices Not Adding Staff for MACRA Implementation

by Jacqueline Belliveau

About 87 percent of physician practices do not plan on hiring additional healthcare staff to help with MACRA implementation, a recent Physicians Practice survey showed. The survey of over 1,000 practice managers and physicians revealed that most...

Data Analytics, Collaboration Critical to MACRA Implementation

by Jacqueline Belliveau

Healthcare providers need to restructure many aspects of their organization for successful MACRA implementation, including data analytics capabilities, financial risk assumption, stakeholder partnerships, and patient engagement strategies, according...

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