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

Merit Based Incentive Payment System

Only 37% of MIPS Quality Measures Deemed Valid by ACP

April 23, 2018 - The American College of Physicians (ACP) is calling for a “time-out” to assess and improve Merit-Based Incentive Payment System (MIPS) quality measures after finding few of the measures used to determine clinician performance and payment adjustments in the program were valid. According to ACP’s criteria, only 37 percent of the 271 quality measures used in MIPS are valid,...


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Dissecting Merit-Based Incentive Payment System Reporting

by Jacqueline Belliveau

*UPDATE: CMS extended the MIPS reporting deadline to Tuesday, April 3, 2018, at 8:00 pm EDT, according to an email sent on March 29. Eligible clinicians participating in MACRA’s Merit-Based Incentive Payment System (MIPS) must submit their...

MIPS Will Impede Value-Based Purchasing Transition, MedPAC Argues

by Jacqueline Belliveau

The Medicare Payment Advisory Commission (MedPAC) recently suggested that Congress repeal the Merit-Based Incentive Payment System (MIPS), arguing the new value-based purchasing program “impedes the movement toward high-value care.”...

Should Congress Repeal the Merit-Based Incentive Payment System?

by Jacqueline Belliveau

As over 400,000 eligible clinicians prepare to submit data to the Merit-Based Incentive Payment System (MIPS) by the end of March, industry experts are urging policymakers and HHS officials to reconsider and even repeal MACRA’s most popular...

Login, Submit Data Early for MIPS Reporting Success, CMS Advises

by Jacqueline Belliveau

Eligible clinicians should log into the reporting system and upload 2017 performance data as soon as possible for Merit-Based Incentive Payment System (MIPS) reporting success, CMS recently suggested in an email. Eligible clinicians reporting...

Clinicians, MedPAC Criticize the Quality Payment Program, MIPS

by Jacqueline Belliveau

Almost three-quarters (71 percent) of clinicians are “not very comfortable” or “not comfortable at all” with new measures under MACRA’s Quality Payment Program, and about 62 percent perceive the program’s measures...

CMS Releases Quality Payment Program Data Submission System

by Jacqueline Belliveau

Eligible clinicians participating in MACRA’s Quality Payment Program can now start submitting their 2017 performance data on a new system on the program’s website, CMS recently announced in a press release. Medicare clinicians must...

Orgs Argue MIPS Adjustments for Drug Payments Harm Patient Access

by Jacqueline Belliveau

Applying Merit-Based Incentive Payment System (MIPS) adjustments to Medicare Part B drug payments will restrict patient access to critical treatments, 11 medical societies recently told congressional leaders. The medical societies, including...

The Pros and Cons of Quality Measure Choices In MACRA, MIPS

by Jacqueline Belliveau

Uprooting the fee-for-service payment system and changing the way clinicians provide care is no easy feat. With this in mind, CMS designed MACRA’s Merit-Based Incentive Payment System (MIPS) to gradually ramp up participation and offer...

Industry Orgs Concerned with 2018 MACRA Implementation Rule

by Jacqueline Belliveau

Industry groups, including the American Medical Group Association (AMGA) and the Medical Group Management Association (MGMA), are questioning if the new 2018 MACRA implementation rule truly promotes value-based care. In recent comments on the...

CMS Issues 2018 MACRA Implementation, Quality Payment Program Rule

by Jacqueline Belliveau

CMS recently issued a final 2018 MACRA implementation rule, detailing the requirements for Quality Payment Program participation in 2018. “CMS listened to feedback from the healthcare community and used it to inform policy making,”...

AMA Pres: Align MIPS Improvement Activities with APM Demands

by Jacqueline Belliveau

Providers can ensure their investments in the Merit-Based Incentive Payment System (MIPS) are worth it by engaging in Improvement Activities and other practice transformations that enhance overall Medicare performance and lead them to the alternative...

4 Strategies for Merit-Based Incentive Payment System Success

by Jacqueline Belliveau

Medicare providers who qualify to participate in MACRA’s Merit-Based Incentive Payment System (MIPS) face up to a 4 percent incentive payment or penalty based on their performance in 2017. Despite MIPS putting revenue at risk, many providers...

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

by Jacqueline Belliveau

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,...

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...

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...

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...

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