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

Quality measures

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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Stakeholders Back Standard ACO Measures for Commercial Orgs in CA

by Jacqueline Belliveau

The Integrated Healthcare Association (IHA) and Pacific Business Group on Health (PBGH) recently embarked on a joint mission to standardize accountable care organization (ACO) measures for quality and cost performance and benchmarking for commercial...

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...

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...

Cost Data to Improve Quality Reporting, Value-Based Purchasing

by Jacqueline Belliveau

Providers enter value-based purchasing contracts without understanding the cost of quality reporting on measures listed in their contracts and payers rarely use cost data to determine which metrics to use when linking reimbursement to...

NQF Eyes Adding Social Risk Factors to Value-Based Purchasing

by Jacqueline Belliveau

In response to stakeholder concerns that value-based purchasing programs unfairly penalize providers who treat greater proportions of disadvantaged patients, the National Quality Forum (NQF) recently endorsed 17 quality measures that address...

Exploring Quality Measures Under Value-Based Purchasing Models

by Jacqueline Belliveau

CHICAGO – Jason Goldwater, MPA, MA, Senior Director of the National Quality Forum, recently likened the value-based purchasing transition to the evolution of music at Xtelligent Media’s Value-Based Care Summit in Chicago. Music started...

CMS Report Details Impact of Widespread Quality Measures

by Jacqueline DiChiara

Centers for Medicare and Medicaid Services (CMS) announces the release of a new CMS report, the 2015 National Impact Assessment of Quality Measures Report, a comprehensive assessment of CMS’ quality measures. The report employs nine key...

Are Healthcare Quality Measures ‘Over-Built?’

by Ryan Mcaskill

In an open letter to CMS, MedPAC warns that the sheer number of quality measures could be creating problems. Healthcare quality measures have become a major priority in recent years for many hospitals. With the growing need for healthcare organizations...


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