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

MACRA Implementation

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...

One-Third of Healthcare Execs Ready for MACRA Implementation

by Jacqueline LaPointe

Only 35 percent of healthcare executives said that their organization has a MACRA implementation strategy and feels prepared for the new value-based reimbursement program, according to a recent Health Catalyst and peer60 survey. The...

Stakeholders Propose 4 MACRA Physician-Focused Payment Models

by Jacqueline LaPointe

MACRA’s Quality Payment Program offers 5 percent maximum incentive payments if eligible clinicians sufficiently participate in an Advanced Alternative Payment Model (APM) from 2017 to 2022. But many specialists are still waiting for...

MACRA Implementation, Healthcare Consumerism Trends at HIMSS17

by Jacqueline LaPointe

As healthcare stakeholders are packing their bags for the upcoming HIMSS17 conference in sunny Florida, many are expecting to learn about the hottest healthcare revenue cycle management topics from the past year. From MACRA implementation...

How Radiologists Can Join an Advanced Alternative Payment Model

by Jacqueline LaPointe

Radiologists may want to look to the physician-focused payment model path in MACRA to develop specialty-specific Advanced Alternative Payment Models (APM), suggested a recent Journal of the American College of Radiology report. Harvey L....

Patient Care Navigation Program Reduces Cancer Care Costs

by Jacqueline LaPointe

Using non-physician and nurse providers as part of a patient navigation program can significantly lower healthcare costs and utilization for cancer patients while generating a return on investment, a recent JAMA Oncology study...

CMS: Innovation Center Key to APM, MACRA Implementation Success

by Jacqueline LaPointe

In a recent official blog post, CMS Acting Principal Deputy Administrator Patrick Conway, MD, highlighted the federal agency’s Innovation Center’s successes with alternative payment model development, especially as MACRA...

OIG: Provider Support, Health IT Needed for MACRA Implementation

by Jacqueline LaPointe

MACRA implementation has been a major priority for CMS in the past year, but the Department of Health and Human Service’s Office of the Inspector General (OIG) recently found several challenges that could impede Quality Payment...

URAC Calls for Virtual Group Rules in Quality Payment Program

by Jacqueline LaPointe

URAC, a non-profit healthcare accreditation company, recently called on CMS to implement virtual group standards under the Quality Payment Program in 2018 that promote economies of scale for more activities than just reporting...

CMS Unveils New Medicare APMs for Quality Payment Program

by Jacqueline LaPointe

CMS finalized several new Medicare alternative payment models that will qualify for a five percent value-based incentive payment through the Quality Payment Program. The announcement contained bundled payment initiatives for cardiac and...

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