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

Quality Payment Program

Exploring Virtual Groups in the Quality Payment Program, MIPS

October 4, 2018 - Virtual groups enable independent physicians and clinicians in small practices to participate in Medicare’s historic push to transition to value-based reimbursement: the Quality Payment Program. The Quality Payment Program, or QPP, aims to shift the industry away from fragmented fee-for-service payments to a system that reimburses clinicians based on the value of the care they...


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Quality Payment Program Top Regulatory Burden for Practices

by Jacqueline LaPointe

For the second year in a row, medical practice leaders said the Quality Payment Program was their top regulatory burden in 2018. Eighty-percent of the 426 group practice leaders recently surveyed by the Medical Group Management...

Do Proposed Quality Payment Program Changes Support Specialists?

by Jacqueline LaPointe

The American Society of Clinical Oncology (ASCO) recently expressed their concerns with proposed Quality Payment Program changes, arguing the potential implementation policies for the third year of the program do not align with specialty...

How Can CMS Improve MACRA’s Quality Payment Program, MIPS?

by Jacqueline LaPointe

While providers commend CMS for replacing the Sustainable Growth Rate with MACRA and its Quality Payment Program, many still have some reservations about the Medicare program. After completing the first Quality Payment Program performance...

CMS Misses Chance to Move Physician Pay, QPP to Value, AMGA Says

by Jacqueline LaPointe

CMS recently proposed several changes to Medicare physician payments and MACRA’s Quality Payment Program to reduce medical billing and administrative burden. But initial reactions from medical group associations have not been...

CMS Proposes 2019 Physician Payment, Quality Payment Program Changes

by Jacqueline LaPointe

CMS recently proposed major changes to Medicare physician payments and the Quality Payment Program to reduce the administrative burden of medical billing. The potential changes in the Medicare Physician Fee Schedule would save individual...

91% of Eligible Clinicians Participated in 2017 MIPS Reporting

by Jacqueline LaPointe

Approximately 91 percent of all eligible clinicians participated in 2017 Merit-Based Incentive Payment System (MIPS) reporting, exceeding the CMS goal of 90 percent participation in the first year of the Quality Payment Program, the...

Clinicians, MedPAC Criticize the Quality Payment Program, MIPS

by Jacqueline LaPointe

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...

CMS Releases Quality Payment Program Data Submission System

by Jacqueline LaPointe

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...

OIG: Practice Aid, QPP Integrity Needed for MACRA Implementation

by Jacqueline LaPointe

A recent Office of the Inspector General (OIG) investigation found two major vulnerabilities with MACRA implementation. The HHS watchdog reported that CMS still needs to provide practice-specific technical assistance and implement a...

CMS Issues 2018 MACRA Implementation, Quality Payment Program Rule

by Jacqueline LaPointe

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...

AHA Supports Bundled Payment Cancellation, Voices MACRA Concerns

by Kyle Murphy, PhD

Despite back the decision by CMS to cancel two bundled payment models and modify another, the American Hospital Association contends that the federal agency is moving a bit too quickly in shifting providers to value-based...

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...

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...

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...

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