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

MACRA Implementation

Industry Orgs Back 2018 MACRA Implementation Flexibilities

by Jacqueline LaPointe

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...

CMS Proposes 2018 Quality Payment Program Changes

by Jacqueline LaPointe

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...

MedPAC Eyes Merit-Based Incentive Payment System Redesign

by Jacqueline LaPointe

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,...

Count Medicare Advantage Patients for Advanced APMs, Orgs Say

by Jacqueline LaPointe

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...

87% of Practices Not Adding Staff for MACRA Implementation

by Jacqueline LaPointe

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...

Data Analytics, Collaboration Critical to MACRA Implementation

by Jacqueline LaPointe

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,...

10 Orgs Call for Medicare Advantage APMs to Qualify for MACRA

by Jacqueline LaPointe

A coalition of ten healthcare industry groups recently urged HHS Secretary Tom Price to weigh risk-based Medicare Advantage alternative payment models the same as Advanced Alternative Payment Models under MACRA. Qualifying participants in...

77% of Practices Seek MIPS Compliance Tech for MACRA Support

by Jacqueline LaPointe

Approximately 77 percent of practices of three or more clinicians are looking to purchase Merit-Based Incentive Payment System (MIPS) compliance technology by the last quarter of 2017 to overcome MACRA implementation challenges, a recent...

AAFP: Drop MIPS APM Pathway to Simplify MACRA Implementation

by Jacqueline LaPointe

The American Academy of Family Physicians (AAFP) recently urged CMS to simplify MACRA implementation to support primary care provider participation in the Quality Payment Program. The industry group called for several Quality Payment...

MIPS Requirements for Clinicians in Small, Rural Hospitals

by Jacqueline LaPointe

In light of the unique challenges eligible clinicians in small and rural hospitals face, CMS developed special Merit-Based Incentive Payment System (MIPS) eligibility and reporting requirements for the clinician group. Through MIPS, CMS...

CMS Expects to Release MIPS Participation Status By May 2017

by Jacqueline LaPointe

CMS anticipates notifying eligible clinicians about their Merit-Based Incentive Payment System (MIPS) participation status for 2017 via letter between late April through May, a recent email from the federal agency stated. The announcement...

2 APMs Take Next Step As MACRA Physician-Focused Payment Models

by Jacqueline LaPointe

Two proposed physician-focused payment models will go to the HHS Secretary for possible limited-scale testing, while one model was stopped from becoming a potential alternative payment model under MACRA, the Physician-Focused Payment Model...

Oncologists Need Data Reporting, Time for MACRA Implementation

by Jacqueline LaPointe

Although MACRA launched the Quality Payment Program on Jan. 1, 2017, a recent American Society of Clinical Oncology (ASCO) report stated that many oncology practices still need to expand or improve services and data reporting to meet the...

MIPS Reporting Success Depends on Choosing Suitable Measures

by Jacqueline LaPointe

For Merit-Based Incentive Payment System (MIPS) reporting success, eligible clinicians should report on quality measures that they know their practice already performs well on, advised Michael Abrams, MA, a managing partner at the...

64% of Healthcare Providers Not Ready for MACRA Implementation

by Jacqueline LaPointe

Even though MACRA’s Quality Payment Program started on Jan. 1, approximately 64 percent of healthcare providers stated that they were either unprepared or very unprepared for MACRA implementation in a February 2017 survey by...

MGMA to CMS: Notify Clinicians About MIPS Eligibility ASAP

by Jacqueline LaPointe

The Medical Group Management Association (MGMA) recently called on CMS Administrator Seema Verma to immediately release Merit-Based Incentive Payment System (MIPS) eligibility notifications as well as approved vendor lists and hospital or...

AHA Critiques MedPAC’s Potential MACRA Implementation Changes

by Jacqueline LaPointe

The American Hospital Association (AHA) recently responded to potential MACRA implementation changes discussed at the Medicare Payment Advisory Commission’s (MedPAC) January meeting. The industry group called on MedPAC to “draw...

Exploring MIPS Advancing Care Info, Improvement Activities

by Jacqueline LaPointe

At HIMSS17, CMS leaders took the stage to ease provider concerns about the newly launched Quality Payment Program and its more popular value-based reimbursement track, the Merit-Based Incentive Payment System (MIPS). Following up on their...

CMS Awards $100M for Small, Rural Clinician MACRA Help

by Jacqueline LaPointe

ORLANDO - CMS recently selected 11 healthcare organizations to receive a total of $100 million in funding to help small and rural eligible clinicians participate in the newly-launched MACRA. Each organization received $20 million to...

MGMA to Price: Simplify MACRA, Reassess Alternative Payment Models

by Thomas Beaton

MGMA would like HHS Secretary Tom Price to reduce the regulatory burdens of HIPAA and MACRA, reassess the development of Alternative Payment Models (APMs), and postpone implementation of the ONC’s 2015 Certified EHR criteria, the...

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