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

Merit Based Incentive Payment System

CMS Proposes 2018 Quality Payment Program Changes

June 21, 2017 - 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 be to increase the Quality Payment Program participation threshold. The federal agency stated that the new rule would exclude eligible clinicians or...


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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...

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...

77% of Practices Seek MIPS Compliance Tech for MACRA Support

by Jacqueline Belliveau

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 Black...

AAFP: Drop MIPS APM Pathway to Simplify MACRA Implementation

by Jacqueline Belliveau

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 Program...

MIPS Requirements for Clinicians in Small, Rural Hospitals

by Jacqueline Belliveau

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 aims...

CMS Expects to Release MIPS Participation Status By May 2017

by Jacqueline Belliveau

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 (via...

Oncologists Need Data Reporting, Time for MACRA Implementation

by Jacqueline Belliveau

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 program’s...

MIPS Reporting Success Depends on Choosing Suitable Measures

by Jacqueline Belliveau

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 healthcare...

64% of Healthcare Providers Not Ready for MACRA Implementation

by Jacqueline Belliveau

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 Stoltenberg...

MGMA to CMS: Notify Clinicians About MIPS Eligibility ASAP

by Jacqueline Belliveau

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 patient-facing...

AHA Critiques MedPAC’s Potential MACRA Implementation Changes

by Jacqueline Belliveau

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 upon...

Exploring MIPS Advancing Care Info, Improvement Activities

by Jacqueline Belliveau

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 MIPS...

Understanding 2017 MIPS Quality, Cost Performance Categories

by Jacqueline Belliveau

CMS leaders at HIMSS17 were not shy with telling session attendees that they are currently in the first Quality Payment Program performance year. To help providers better understand the program, which launched on Jan. 1, the federal agency’s...

AMGA: Drop Transition, Add MSSP Track for MACRA Implementation

by Jacqueline Belliveau

With the Quality Payment Program set to launch on Jan. 1, 2017, the American Medical Group Association (AMGA) provided CMS with several MACRA implementation suggestions, including transition year elimination by 2018 and Medicare Shared Savings...

How Palliative Care Can Maximize Value-Based Reimbursement

by Jacqueline Belliveau

Providers can boost value-based reimbursement success by incorporating early palliative care into routine cancer care delivery, a new study in the American Journal of Managed Care indicated. Researchers at the Center to Advance Palliative Care...

Top 5 Facts About the Merit-Based Incentive Payment System

by Jacqueline Belliveau

In October, CMS released the final MACRA implementation rule that will put the Quality Payment Program into action on Jan. 1, 2017. Under the new value-based reimbursement program, the federal agency anticipates 592,000 to 642,000 Medicare providers...

Key Ways to Succeed Under MACRA’s Quality Payment Program

by Jacqueline Belliveau

Do not feel overwhelmed by the upcoming Quality Payment Program, a healthcare expert at CAPG, a non-profit trade association for accountable physician organizations, advised the projected 592,000 to 642,000 eligible clinicians participating in...

CMS Finalizes MACRA Implementation, Quality Payment Program

by Jacqueline Belliveau

CMS released the long-awaited final rule on MACRA implementation earlier today, which stated that the new value-based reimbursement system will start on Jan. 1, 2017. The final MACRA implementation rule will replace the Sustainable Growth Rate...

How CMS Would Reimburse ACOs for Value-Based Care under MIPS

by Jacqueline Belliveau

With a final rule on implementing MACRA coming in the next couple of months, some accountable care organizations (ACOs) have started to analyze new value-based reimbursement structures under the proposed rule. While only a couple of Medicare...

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