HITapproved Industry Highlights
The financial, clinical and technical underpinnings of implementing an effective Quality Payment Program strategy have introduced a new level of complexity to many healthcare organizations. Providers have made big investments in IT infrastructure designed to help bring a modern, data-driven business approach to an industry ready to quantify healthcare outcomes. Unfortunately, many providers struggle to find and dedicate the time and resources required to maximize return on those investments. For many, internal expertise is the missing link.
It’s worth remembering that 2016 was dubbed the “year of data security” after 90 percent of healthcare providers suffered data breaches in the previous two years. In particular, the Anthem breach of late 2014/early 2015 got everyone’s attention for the sheer magnitude (around 80 million records) of the hack. Looking back, we can say 2016 lived up to its name as the number of records accessed was significantly lower than the year prior. But IT security is a game of whack-a-mole, so if fewer patient records were lost, malevolent forces simply found other ways to make the lives of healthcare CIOs very difficult.
In the inaugural reporting year of MACRA’s new Quality Payment Program, quality measures and clinical practice improvement activities will collectively account for 85 percent of MIPS composite scores used to determine Medicare reimbursement penalties and incentives for healthcare providers. As clinicians prepare to embark upon MIPS reporting, knowledgeability on clinical performance metrics and standing heading into and throughout QPP participation will be essential to meeting reporting and care delivery objectives under the new value-based payment model.
When it comes to government regulations and health care, change is inevitable. In contrast to the current fee-for-service care, the value-based care model aims to compensate physicians for high-quality service, clinical performance, and patient satisfaction. It’s an exciting time for the future of healthcare, and small practices are uniquely situated to thrive in the transition to value-based care. One of the top concerns for physicians is the effect value-based care will have on revenue. According to Medical Economics, in the past three years, only 6 percent of total physician pay was tied to quality measures but is projected to jump to 20 percent under MACRA.
By Emily Walters, Freelance Content Writer Picture this: Troy is sitting on a crowded bus headed towards Grand Central Station. He just came back from three months of volunteering overseas and knows that there’s an extremely slight chance he was exposed to Ebola during his travels. Like most people in his position would, Troy is getting right back to his typical routine. But he isn’t as irresponsible as you might think. He knows that Ebola has an incubation period and he would not be contagious until he started showing symptoms. Troy […]
With 2017 upon us, many practices are scrambling to understand the Quality Payment Program final rule. The final rule was published on October 14, 2016 with CMS making significant revisions to the proposed rule. In the final rule, CMS increased the flexibility of the Medicare Access and CHIP Reauthorization Act (MACRA) by introducing an option-based implementation plan, titled “Pick Your Pace,” which allows providers to ease into MACRA for the 2017 reporting year.
With kickoff of the inaugural MACRA reporting period nearly upon us, many healthcare providers will greet 2017 with quality payment program objectives top-of-mind. The new pay-for-performance reimbursement landscape will usher in the adoption of new clinical and technical workflows as physicians work to meet the goal of driving better patient outcomes through smarter healthcare resource utilization. The cornerstone of these initiatives, however, is an effective financial strategy.
As the market responds to continued pressure to reduce healthcare costs – and with costs expected to consume 20% of the US economy by 2020 – the march to value-based care will pick up speed in 2017. Healthcare pundits have been focusing on how the ACA will be repealed or replaced—but don’t let that noise distract you. In reality, the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) is the legislation that mandates the transition to value-based care – and no one in Washington is considering repealing it.
When CMS released the Notice of Proposed Rule (NPRM) for the implementation of the Medicare Access and CHIP Reauthorization Act – better known as MACRA – in April of this year, howls of protest could be heard throughout the healthcare landscape.