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

MACRA

100+ Medical Orgs Want MACRA Implementation Flexibilities Extended

by Jacqueline LaPointe

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...

Specialists Face 16% MIPS Payment Adjustment Swing Under Proposal

by Jacqueline LaPointe

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...

MedPAC Calls for MIPS Repeal, Voluntary Program Replacement

by Jacqueline LaPointe

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...

MIPS Quality Reporting Flexibilities Trouble Providers, EHR Vendors

by Jacqueline LaPointe

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...

Specialists Lack Medicare Alternative Payment Model, MACRA Options

by Jacqueline LaPointe

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...

Few Specialists Prepared for MACRA Implementation, MIPS Reporting

by Jacqueline LaPointe

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...

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

by Jacqueline LaPointe

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...

CMS May Cancel Upcoming Cardiac, Ortho Bundled Payment Models

by Jacqueline LaPointe

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...

Quality Payment Program, MIPS Top 2017 Regulatory Burden List

by Jacqueline LaPointe

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...

Physician Expert, Clinical Documentation Key to MIPS Success

by Jacqueline LaPointe

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...

Surveys Reveal MACRA Implementation, QPP Knowledge Lacking

by Jacqueline LaPointe

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...

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...

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