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PQRS ReportingValue-Based Payment Modifier
March 3, 2015

PQRS 2015 Reporting: How to Go Beyond Basics to Improve Outcomes

Chances are you don’t have time to read through all 1,200 pages of Medicare’s Final Reporting Rule. But if you don’t understand how CMS is moving the Medicare program, and the health care system at large, toward rewarding providers for quality rather than quantity of care, your organization is in for a rude awakening. In 2015, PQRS is now mandatory; you must meet full reporting requirements to avoid a penalty. No more safety nets. Successful reporting means you need to understand the interplay between PQRS and the Value-Based Payment Modifier (VBPM), which rewards only those practices that outperform their competition…
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Population HealthPQRS ReportingQualified Clinical Data Registry ReportingValue-Based Payment Modifier
February 10, 2015

Navigating the ACO Labyrinth to Success: How to Find Your Way to Quality and Shared Savings

Last year, less than one quarter of Medicare MSSP ACOs achieved success in generating shared savings. Not a good report card, given that Accountable Care Organizations form for the explicit purpose of delivering high quality, coordinated care, with shared savings as in incentive to avoid duplication of services. But ACOs are complex endeavors, both administratively and clinically. Better coordination of patient care does not guarantee success. Your efforts must be complemented by a solid understanding of Medicare’s basic rules for quality reporting and methods of attributing patients to the ACO, so that you can keep your patients within the network.…
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Future of Health CareResearch
November 25, 2014

Health Care 2014: Where Do We Go from Here?

This week, many of us will sit around Thanksgiving tables, giving thanks for our families and friends, food and shelter, and living in this good land. We might also say, this land where we have access to some of the best health care on earth. So how interesting that we have spent the last several years waging war on every part of health care—the building of it, buying it, paying for it, measuring its value and delivering it. How did we get here? Have we lost trust in health care as we’ve lost trust in government? Or, perhaps there is…
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Population HealthPQRS ReportingValue-Based Payment Modifier
November 18, 2014

PQRS 2015: How Your Practice and Patients Can Benefit from New Population Health Measures

Good news for providers who have criticized PQRS as mundane and want to improve assessment of patient outcomes and reduce gaps in care: Medicare’s PQRS 2015 Rule is shifting away from rewarding fragmented quality services and toward population health. With the expansion of the related Value-Based Payment Modifier (VBPM), every group can turn population health into higher Medicare revenues, so long as you have strong, patient-centric processes—and data capture. If you don’t, you may suffer penalties. What’s a Cross-Cutting Measure and How Does It Work? CMS has established a set of Cross-Cutting Measures to provide a broader evaluation of care…
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PQRS ReportingQualified Clinical Data Registry ReportingValue-Based Payment Modifier
November 11, 2014

Specialists at Risk: How To Navigate Hazards in Medicare’s Value-Based Purchasing Programs

Heads up, specialty providers. The future of your practice may depend on three key components in Medicare’s Value-Based Purchasing program. Especially if you work in an independent practice with a higher proportion of Medicare patients than many primary care physicians, your income and practice survival are at risk if you don’t understand implications of the new Rule for 2015. This is certain: You must manage the new environment to avoid penalties and losses under these programs. Most important are PQRS 2015, Value-Based Payment Modifier (VBPM) and ACO Participation. That’s the foundation; with requirements getting tougher every year, you need to…
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PQRS ReportingQualified Clinical Data Registry Reporting
September 25, 2014

How to Integrate Strategic Quality Initiatives with PQRS Reporting: The QCDR Opportunity

For 2014 and beyond, CMS has created a new mechanism for PQRS reporting—the Qualified Clinical Data Registry. QCDR reporting requirements are the same as for a traditional Registry utilizing individual measures: A provider must report on at least nine measures. These measures must represent at least three National Quality and Strategy (NQS) Domains. Each of the nine measures must be completed for at least 50 percent of eligible patients or cases. However, a QCDR has features that can bring more to PQRS performance and reporting. QCDRs are designed to foster improvement in the quality of care provided to patients.  A…
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PQRS Reporting
September 15, 2014

Still Not Sure of Your PQRS 2014 Strategy? Delays Will Cost You

If your organization is just beginning to think about PQRS reporting for 2014, beware. End-of-year data collection is no longer enough to meet PQRS requirements. That’s because PQRS is no longer a quality “reporting” program; it’s now all about performance. In fact, waiting to determine your 2014 PQRS strategy until the last minute is actually very risky and could jeopardize both performance and future revenue. Although reporting through a qualified Registry extends your deadline (for 2014, CMS will not close its portal until March 31, 2015), the new Value-Based Payment Modifier (VBPM) requires more lead time to demonstrate good results.…
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