Updates to the Quality Payment Program Year 2

MIPS or Merit-based incentive payment system is one of the two Quality Payment Programs launched by MACRA, the other one being APMs or Alternative Payment models to reward clinicians. MIPS has four connected performance categories that will affect your Medicare payments: Quality, Improvement Activities, Advancing Care Information and Cost. 

Let me begin by looking at CMS’s current status:

1. What CMS has been doing to encourage clinicians to participate in these programs?
2. How to become eligible to participate in MIPS?
3. Form a multi-disciplinary team
4. Decision Making & Reporting
5. Changes in 2018
6. Closely follow CMS for changes and /or updates

Click here to view - Prepare for MIPS 2018

Source On:- Medical Billing Star

4 Thoughts on successful RCM Audit

Regular RCM audits have become an absolute necessity to run a successful and compliant medical practice. This infographic explains in detail the four tips shared by healthcare administrative and revenue cycle expert Karen Bowden, to conduct successful RCM audits. Her thoughts were recently published in Becker’s Hospital Review

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Source On:- MedicalBillingStar

Healthcare RCM Automation trends 2017

There is an unprecedented demand for revenue cycle management outsourcing and IT consulting services in the healthcare industry. A recent survey by marketing research giant, Black Book, reflects this trend. Hospitals are taking bold and informed decisions on outsourcing, adopting healthcare technology, working with bolt on applications and newer data architectures, according to the survey. This infographic reveals some of the most ground-breaking information revealed by the survey.

Click here to view more - Healthcare IT Trends

Facts of MACRA & RCM Challenges

MACRA is round the corner. But there’s no need to panic. Armed with the right information healthcare organizations can, not just tackle but capitalize on MACRA. This infographic details the difference between MIPS and APMs. And expert advice on following best practices to achieve optimal results.

Click here to view more:- Facts of MACRA

6 revenue cycle metrics you must be tracking

To remain financially stable in the uncertain healthcare space of today it is imperative for healthcare organization to measure Physician Key Performance Indicators. Regular tracking and reporting of reimbursement trends will help decision-makers across the organization to collaborate, visualize and map out effective strategies for financial success. We list out 6 Revenue Cycle metrics that every medical practice should track to stay compliant and profitable in 2017.     

MACRA facts that every clinician should know

MACRA is here and the new program is going to sunset several (un) popular programs such as Meaningful Use and the Value Based Payment Modifier model. Everybody who is anybody is busy discussing about MACRA and its ramifications. But as with any big updates the myths are jostling for space with the facts. We’ve sifted the facts from the myths for you.

Myth #1: MACRA will make maintenance of certification mandatory

Fact #1: MACRA doesn’t make it mandatory for physicians to participate in maintenance of certification. It is certainly not compulsory.

Myth #2: MACRA will affect only physician reimbursement.

Fact #2: There is a common myth that MACRA will only affect physician reimbursements. It will affect the reimbursement of all eligible clinicians. The eligible clinicians who will have to report under MIPS are physicians, physician assistants, nurse practitioners, clinical nurse specialists, certified registered nurses and anesthetists.

Myth #3: Clinicians can choose between MIPS and  participating in AAPMs right at the outset.

Fact #3: All eligible clinicians will report under MIPS during the first year. CMS will select qualifying physicians to participate in AAPMs after evaluating their quality scores.

Myth #4: MIPS penalties are higher than the current quality measure programs

Fact #4: MIPS stream lines and consolidates 4 different programs under one umbrella. Instead of paying separate and sometimes expensive penalties for failing to meet different pay for performance programs, clinicians who report under MIPS will only have to pay a 4% penalty during the first year.

Myth #5: MACRA will penalize physicians who follow the fee for service model

Fact #5: It does not. Physicians can still choose to continue working with the FFS model can still participate in the MIPS program.

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Healthcare CFO's Top Challenges

“We really do believe much harder times are coming from a reimbursement standpoint”, Daniel Morissette, Stanford Health Care CFO.

With value based model, the most unpredictable payment reform, in their list of financial challenges, CFOs point out their threats and decision making factors.

“We’re trying to evaluate all of the different services we have and evaluate how they will fit into what we believe is the future of healthcare”, Donald Longpre, CFO, North Ottawa Community Health System

“It’s not just the fact that we’re going to get paid less for what we’re doing. We’re also seeing a shift in business,” Chris Bergman, CFO, Christ Hospital Network, Cincinnati. CMS is nipping at little things”, Bergman said on what was worrying him.

When it comes to experience:

“You need to understand the issues, test your theories, and subtly verify your assumptions along the way,” says Tom Gibney, CFO of St. Luke’s Cornwall Hospital of Newburgh, New York, when asked about how experience plays a role in decision making. “The buck stops with you,” he says. “The board is looking to you for answers”, he quoted.

Reimbursement declines, physicians shortage, healthcare reforms and other factors have forced CFO’s to use their experience in answering how to recoup the losses and improve the organization’s cash flow.

We organized the data collected from recent surveys to find out the challenges of healthcare CFOs in a value based era and the factors which influence their decision. Based on the results here’s a data driven answer.

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