Archive for: QPP

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Payment Innovation: Quality Payment Program

CMS Updates QPP Resources

CMS has updated the QPP resource library.

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Payment Innovation: Quality Payment Program

CMS Updates QPP Resources

CMS has added additional resources to the QPP Resource Center.

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Payment Innovation: MIPS

93% of MIPS Eligible Clinicians Will Receive a Positive MIPS Payment Adjustment in 2019

CMS has announced that 93 percent of MIPS eligible clinicians will receive a positive MIPS payment adjustment in 2019 based on their performance in 2017. Overall, 95 percent of eligible clinicians avoided a negative payment adjustment. The chart below summarizes the results.

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Payment Innovation: Quality Payment Program

CMS Updates QPP Resources

CMS has uploaded a number of new resources to the QPP resource center, including web-based training courses.

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Payment Innovation: MIPS

CMS Extends Cost Measure Field Testing to Nov. 5

CMS is extending the timeframe for submitting feedback on the 2018 field testing of cost measures until Monday, November 5, 2018, at 12:00 pm EDT.

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Payment Innovation: PTAC

GAO Makes PTAC Appointments

On October 18, 2018 the GAO announced the appointment of two new members to the Physician-Focused Payment Model Technical Advisory Committee (PTAC).

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Payment Innovation: Quality Payment Program

Upcoming QPP Webinars

CMS has scheduled several QPP webinars geared towards Physicians Compare and the CMS Web Interface for ACOs and Groups

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Payment Innovation: MIPS

QPP Website Update: 2018 Performance Feedback for MIPS Quality Data Submitted via Claims Now Available

CMS has updated the QPP website so individual eligible clinicians who choose to submit their Quality performance category data via claims can access performance feedback for the 2018 performance year on an ongoing basis.

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Payment Innovation: MIPS

CMS Announces Field Testing of 13 Cost Measures through October 31, 2018

CMSis conducting field testing for 13 cost measures before consideration of their potential use in the MIPS cost performance category in 2020 or beyond. Note: These are not the same measures currently in use for the 2017 and 2018 MIPS performance periods.

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Payment Innovation: MIPS

CMS Hosts Webinar on Patient Relationship Categories and Codes

CMS to host webinar on patient relationship categories and codes on Wednesday, October 17, 2018.

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Payment Innovation: MIPS

CMS Opens Virtual Groups Election Period for MIPS 2019 Performance Year

CMS recently opened the annual virtual group election period for the MIPS 2019 Performance Year.

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Payment Innovation: MIPS

Save the Date: Physician Compare National Provider Call

Save the Date: Physician Compare National Provider Call October 3, 2018 1:30 – 3:00 PM ET

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Payment Innovation: MIPS

QPP Developer Resource: CMS Open Sources Code for Developers that Calculates QPP Quality Measures from Claims Data

CMS open-sources QPP code responsible for calculating quality measures from Medicare claims data submitted by eligible clinicians via Quality Data Codes. This code is intended for developers interested in the calculation mechanism supporting QPP Claims to Quality.

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Payment Innovation: MIPS

CMS Announces Field Testing of Cost Measures

CMS and its contractor, Acumen, will conduct field testing in October 2018 for 13 cost measures. These measures will be considered for use in the MIPS Cost Performance Category in 2020 or beyond.

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Payment Innovation: MIPS

Representative DelBene Circulates Dear Colleague Letter on MIPS Low Volume Threshold

Rep. DelBene (D-WA) requests support in asking CMS to adjust the MIPS low-volume threshold in order to include more providers in MIPS as part of the final 2019 physician fee schedule.

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Payment Innovation: MIPS

CMS Awards Funding for Quality Measure Development

CMS announces the selection of seven applicants to receive cooperative agreement awards through the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) Funding Opportunity: Measure Development for the Quality Payment Program (QPP).

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Payment Innovation: MIPS

MIPS Resource: CMS Posts Infographic on 2019 Payment Adjustments

CMS recently posted an infographic on 2019 MIPS adjustments for the 2017 Performance Year.

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Payment Innovation: MIPS

UPDATED: CMS Announces “Slight” Adjustments to 2017 Final MIPS Scores

CMS announces “slight” adjustments to some 2017 MIPS final scores.

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Payment Innovation: MIPS

CMS Hosts Virtual Office Hours on the 2019 MIPS Performance Period Self-Nomination Process

On September 20, 2018, CMS is hosting a virtual office hours session on the 2019 MIPS self-nomination process.

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Payment Innovation: MIPS

2018 MIPS Resources for Anesthesiologists, Cardiologists and Radiologists Posted on QPP Resource Center

CMS has posted resource documents on the Merit-based Incentive Payment System (MIPS) for anesthesiologists, cardiologists and radiologists.

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Payment Innovation: MIPS

CMS Posts 2018 MIPS Data Validation Criteria

CMS posts validation criteria for the 2018 Merit-based Incentive Payment System (MIPS) program.

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Payment Innovation: Innovation Center

CMS Releases Next Gen ACO Model Evaluation

CMS released the first annual report on the Next Generation Accountable Care Organization (ACO) model.  The report provides results from the 18 active Next Gens who participated beginning January 2016.

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Payment Innovation: MIPS

CMS Posts Virtual Groups Toolkit for 2019 MIPS Performance Year

CMS hosts virtual group webinar on August 27, 2018 at 2pm ET

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Payment Innovation: Quality Payment Program

CMS Releases First Snapshot of 2018 APM Qualifying Participant and MIPS APM Status

CMS updated the Quality Payment Program Participation Status Tool to include 2018 Advanced Alternative Payment Model Qualifying Participant and Merit-based Incentive Payment System APM status.

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Payment Innovation: MIPS

CMS Hosting Several MIPS-related Conference Calls

The Centers for Medicare & Medicaid Services (CMS) has announced they are hosting several Merit-based Incentive Payment System (MIPS)-related conference calls.

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Payment Innovation: MIPS

CMS Launches MAQI Demonstration Website

The Centers for Medicare and Medicaid Services (CMS) posted a webpage dedicated to the Medicare Advantage Qualifying Payment Arrangement Incentive (MAQI) demonstration.

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Payment Innovation: MIPS

CMS Extends Deadline for MIPS Targeted Review to October 1, 2018

MIPS 2017 Performance Feedback Users Guide now available

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Payment Innovation: Regulation

CMS Releases the CY 2019 PFS Proposed Rule

Includes proposals for physician payment and the Medicare Quality Payment Program

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Payment Innovation: MIPS

GOP Doctors Caucus Asks CMS to Reduce MIPS Exemptions

On July 3, 2018, five members of the House Republican Doctors Caucus asked CMS Administrator Seema Verma to reduce the number of clinicians excluded from the Merit-Based Incentive Payment System (MIPS) in 2019.

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Payment Innovation: MIPS

QPP Year 1 Update: CMS Informs MIPS Participants of their 2019 Payment Adjustments

The Centers for Medicare & Medicaid Services (CMS) released 2017 Merit-based Incentive Payment System (MIPS) performance feedback.

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Payment Innovation: MIPS

MIPS Preliminary Performance Feedback Data Is Available

Eligible clinicians that submitted 2017 Merit-based Incentive Payment System (MIPS) data through the Quality Payment Program website, can review their preliminary performance feedback. MIPS final scores and feedback will be available in July.

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Payment Innovation: MIPS

CMS Announces 91% Participation for Year 1 of MIPS

The Centers for Medicare and Medicaid Services (CMS) announced that 91 percent of all clinicians eligible for the Merit-based Incentive Payment System (MIPS) participated in the first year of the Quality Payment Program (QPP). 

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Payment Innovation: Innovation Center

Feedback Solicited on Opioid Alternative Payment Model

The American Medical Association (AMA) and the American Society of Addiction Medicine (ASAM) are soliciting feedback on a proposed alternative payment model (APM)

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Payment Innovation: Quality Payment Program

Earn Improvement Activity Credit in 2018 for Participating in a Study on the Burden of Quality Measure Reporting

Clinicians and groups who are eligible for the Merit-based Incentive Payment System (MIPS) that participate successfully in the study will receive full credit for the 2018 MIPS Improvement Activities performance category.

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Payment Innovation: Quality Payment Program

CMS Hosts Two-Part Webinar Series on Quality Measures

The Centers for Medicare and Medicaid Services (CMS) is hosting a two-part webinar series that covers an introduction to quality measures, overview of the measure development process, how the public can get involved.

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Payment Innovation: Innovation Center

Adam Boehler Named as Head of CMS Innovation Center

On Friday, April 6, 2018, Health and Human Services Secretary Alex Azar named Adam Boehler, the founder and former CEO of Landmark Health, as the deputy administrator and director of the Centers for Medicare & Medicaid Services (CMS) Innovation Center. Created under the Obama Administration through the Affordable Care Act, the CMS Innovation Center supports the development and…

ORIGINAL ANALYSIS

Payment Innovation: Quality Payment Program

CMS Releases 2018 MIPS Eligibility Tool

The Centers for Medicare and Medicaid Services (CMS) updated their MIPS Participation Tool for the 2018 MIPS program. By entering a National Provider Identification (NPI) number, clinicians can determine if they are eligible to participate in the 2018 MIPS program.

ORIGINAL ANALYSIS

Payment Innovation: PTAC

PTAC Recommends Models for Implementation and Limited Scale Testing at March 2018 Meeting

The Physician-Focused Technical Advisory Committee (PTAC) met March 26-27, 2017, in Washington, DC, to review four proposed payment models.

ORIGINAL ANALYSIS

Payment Innovation: Quality Payment Program

MedPAC Recommends Elimination of MIPS and Adoption of Alternative Approach in March 2018 Report to Congress

On Thursday, March 15, 2018, the Medicare Payment Advisory Commission (MedPAC) released its semiannual report to Congress with a recommendation to eliminate the Merit-Based Incentive Payment System (MIPS) and replace it with an allegedly less burdensome program referred to as the Voluntary Value Program (VVP).

ORIGINAL ANALYSIS

Payment Innovation: Quality Payment Program

AMA Asks OIG for APM Safe Harbors

The American Medical Association (AMA) recently submitted a letter to the Office of the Inspector General (OIG) to create a safe harbor to facilitate coordinated care and promote well-designed alternative payment models (APMs).

ORIGINAL ANALYSIS

Payment Innovation: Quality Payment Program

109 Physician Specialty Societies, Large Practice Groups and Patient Advocacy Groups Urge Congress to Remove Part B Drugs from MIPS Payment Adjustment

A collection of 109 organizations representing providers and patients submitted a letter urging Congress to block CMS from applying the Merit-based Incentive Payment System (MIPS) adjustment to Part B drug payments.

ORIGINAL ANALYSIS

Payment Innovation: Quality Payment Program

MedPAC Votes to Replace MIPS

On Thursday, January 11, 2018, the Medicare Payment Advisory Commission (MedPAC) recommended eliminating the Merit-based Incentive Payment System (MIPS) and its related reporting requirements and replacing it with a voluntary value program. Under the proposed model, all clinicians would have a portion of their fee schedule payment withheld. Clinicians then could earn the withhold back…

ORIGINAL ANALYSIS

Payment Innovation: Quality Payment Program

Upcoming CMS Webinars

The Centers for Medicare & Medicaid Services (CMS) has just announced two webinars related to the Quality Payment Program. Upcoming webinars are listed below.

ORIGINAL ANALYSIS

Payment Innovation: Quality Payment Program

CMS Solicits Comments on Specialty Measure Sets

The Centers for Medicare & Medicaid Services (CMS) is accepting recommendations from stakeholders for potential consideration of new specialty measure sets and/or revisions to existing specialty measure sets for program year 2019 of the Merit-based Incentive Payment System (MIPS) program. The current 2018 specialty measure sets are located in the Appendix measure tables of the…

ORIGINAL ANALYSIS

Payment Innovation: Innovation Center

CMS Announces New Voluntary BPCI Advanced Model

On Tuesday, January 9, 2018, the Centers for Medicare and Medicaid Services (CMS) Center for Medicare and Medicaid Innovation (Innovation Center) announced a new voluntary episode payment model, Bundled Payments for Care Improvement Advanced (BPCI Advanced Model) that will test a new iteration of bundled payments for 32 Clinical Episodes. The Advanced BPCI Model will operate…

ORIGINAL ANALYSIS

Payment Innovation: PTAC

PTAC Recommends Two Models for Implementation at December 2017 Public Meeting

The Physician-Focused Technical Advisory Committee (PTAC) met December 18-20, 2017, in Washington, DC, to review seven proposed payment models.

ORIGINAL ANALYSIS

Payment Innovation: Quality Payment Program

2018 MIPS Measures and Activities Posted

The Centers for Medicare and Medicaid Services (CMS) posted documents for the measures and activities for each of the four Merit-based Incentive Payment System (MIPS) performance categories in 2018.

ORIGINAL ANALYSIS

Payment Innovation: Quality Payment Program

CMS Launches Website to Submit 2017 QPP Data

The Centers for Medicare and Medicaid Services (CMS) announced that eligible clinicians participating in the Quality Payment Program (QPP) can begin submitting their 2017 performance data using a new data submission system on the QPP website. Eligible clinicians can use the web-based system to submit their 2017 QPP performance data during the 2017 submission period which…

ORIGINAL ANALYSIS

Payment Innovation: Quality Payment Program

OIG Releases QPP Report: Concludes CMS has Made Progress in QPP Implementation but Challenges Remain

The Office of the Inspector General (OIG) recently released a follow-up report to a 2016 early implementation review of the Quality Payment Program (QPP).

ORIGINAL ANALYSIS

Payment Innovation: Quality Payment Program

CMS Releases List of 22 Measures Under Consideration for the MIPS Program

As required by statute, on November 30, 2017, the Centers for Medicare and Medicaid Services (CMS) released a list of quality measures that are under consideration for Medicare quality reporting and value-based purchasing programs. Of the 32 measures on the list, 22 are being considered for the Merit-based Incentive Payment System (MIPS). The release of…

ORIGINAL ANALYSIS

Payment Innovation: Innovation Center

CMS Finalizes Changes to the Comprehensive Care for Joint Replacement Model, Cancels Episode Payment Models and Cardiac Rehabilitation Incentive Payment Model

On Thursday, November 30, 2017,  CMS released the final rule and interim final rule to implement changes to the Comprehensive Joint Replacement Program (CJR).

ORIGINAL ANALYSIS

Payment Innovation: Regulation

CMS Releases CY 2018 Quality Payment Program (MACRA) Final Rule

Register Today for a Live Webinar – Overview and Analysis of the CY 2018 QPP Final Rule

ORIGINAL ANALYSIS

Payment Innovation: Quality Payment Program

APM Look-Up Tool Posted

Allows clinicians to check their Qualifying Advanced Alternative Payment Model (APM) Participant (QP) status

ORIGINAL ANALYSIS

Payment Innovation: Quality Payment Program

MedPAC Proposes Alternative to MIPS

The Medicare Payment Advisory Commission (MedPAC) proposed an alternative to the Merit-based Incentive Payment System (MIPS) at their October 5, 2017 public meeting. This proposal expanded on their proposal to redesign MIPS found in their June 2017 Report to Congress.

ORIGINAL ANALYSIS

Payment Innovation: Quality Payment Program

Registration Open for 2017 LAN Summit

LAN Hosts Summit on Healthcare Innovation on October 30, 2017

ORIGINAL ANALYSIS

Payment Innovation: Quality Payment Program

CMS and CAPG Host Webinars on APMs

The Centers for Medicare and Medicaid Services (CMS) is collaborating with CAPG to host two webinars on alternative payment models (APMs). Webinar presenters will include experts from both CMS and CAPG.

ORIGINAL ANALYSIS

Payment Innovation: Quality Payment Program

McDermottPlus Releases Hyperlinked Table of Contents of 2018 QPP Proposed Rule

An essential tool for a more efficient review of this critically important proposed rule

ORIGINAL ANALYSIS

Payment Innovation: MIPS

CMS Releases Predictive Analysis on Eligible Clinician QP Status

Based on historical Part B claims analysis, CMS predicts that nearly 100% of eligible clinicians in Advanced APMs will be QPs in performance year 2017

ORIGINAL ANALYSIS

Payment Innovation: Advanced APMs

Organizations Advocate to CMS to Expand Advanced APM Opportunities to Include APMs Under Medicare Advantage

On May 12, 2017, ten organizations submitted a letter to Secretary of Centers for Medicare and Medicaid Services Tom Price urging him to afford physicians and physician groups credit for participation in Medicare Advantage Alternative Payment Models (APMs) for the Advanced APM pathway of the Quality Payment Program (QPP). Under the QPP, physicians who meet…

ORIGINAL ANALYSIS

Payment Innovation: Quality Payment Program

Funding Opportunity: Measure Development for the Quality Payment Program

The Centers for Medicare and Medicaid Services (CMS) has announced a funding opportunity to support developing, improving, updating or expanding quality measures for use in the Quality Payment Program under the Merit-Based Incentive Payment System and/or Advanced Alternative Payment Models.

ORIGINAL ANALYSIS

Payment Innovation: Innovation Center

Health Affairs Blog Launches New Topic: Diffusion of Innovation

On May 16, 2017, the Health Affairs Blog launched a new topic: Diffusion of Innovation. The focus of the blog topic is how innovations are diffused across health care and will continue over the next year followed by the publication of a theme issue in February 2018.

ORIGINAL ANALYSIS

Payment Innovation: PTAC

PTAC Cancels June 2017 Meeting

The Physician-Focused Payment Model Technical Advisory Committee (PTAC) will not be holding a public meeting scheduled for June 5-6. The next scheduled meeting is September 7-8, 2017.

ORIGINAL ANALYSIS

Payment Innovation: Quality Payment Program

Check Your MIPS Eligibility Online at the QPP Website

Clinicians can use their 10-digit National Provider Identification Number to check their 2017 Merit-based Incentive Payment System (MIPS) eligibility on the Quality Payment Program website. Clinicians included in MIPS in 2017, will need to decide whether to report as an individual or with a group. Clinicians exempt from MIPS in 2017, will not need to do anything…

ORIGINAL ANALYSIS

Payment Innovation: Quality Payment Program

CMS to Send MIPS Participation Status Letters in Late April and May

The Centers for Medicare and Medicaid Services (CMS) just announced that practices will be receiving letters in late April and May informing them if they need to participate in Merit-based Incentive Payment System (MIPS) in 2017. The letter will come from the Medicare Administrative Contractor that processes their Medicare Part B claims and will tell them the…

ORIGINAL ANALYSIS

Payment Innovation: Quality Payment Program

CMS and CAPG Host Quality Payment Program Webinar Series

First webinar on MIPS Quality Reporting Scheduled for May 5, 2017 from 3:30 – 4:30 PM ET

ORIGINAL ANALYSIS

Payment Innovation: Other

LAN Spring Forum: Aligning for Action

LAN Hosts Virtual Forum on May 1, from 1-3:30 PM ET

ORIGINAL ANALYSIS

Payment Innovation: Innovation Center

CMMI Hosts Public Listening Session on Radiation Therapy APMs on May 3rd

The Center for Medicare & Medicaid Innovation (CMMI) will hold a public listening session regarding the development of a report to Congress on an alternative payment model for radiation therapy services. The listening session, scheduled for May 3, 2017, will provide an important opportunity for all stakeholders to provide input on the report.

ORIGINAL ANALYSIS

Payment Innovation: PTAC

PTAC Recommends Two Payment Models for Limited-Scale Testing

The Physician-Focused Technical Advisory Committee (PTAC) met April 10-11, 2017, in Washington, DC, to review three proposed payment models. PTAC recommended two of the models, Project Sonar and the ACS-Brandeis Advanced Alternative Payment Model (APM), to CMS for limited-scale testing. PTAC rejected the third proposal, the COPD and Asthma Monitoring Project. A fourth proposal, the Comprehensive Colonoscopy Advanced APM for…

ORIGINAL ANALYSIS

Payment Innovation: Innovation Center

CMS Hosts Oncology Care Model Stakeholder Feedback Opportunity on May 11

CMS is hosting a stakeholder feedback opportunity on the Oncology Care Model (OCM) on Thursday, May 11, 2017 from 1:00-4:00 p.m. EDT. All interested OCM stakeholders are invited to attend this public forum, with the goal of hearing feedback about OCM. The forum will include a brief introduction from the OCM team followed by discussion.…

ORIGINAL ANALYSIS

Payment Innovation: Quality Payment Program

CPT Editorial Panel Considers the Establishment of MACRA-related Modifiers at June 2017 Meeting

The American Medical Association (AMA) CPT® Editorial Panel posted the Proposed Agenda for the June 2017 Panel Meeting. Included on the agenda are two MACRA-related coding proposals.

ORIGINAL ANALYSIS

Payment Innovation: PTAC

PTAC Releases Updated Agenda for April 10-11, 2017 Meeting

On Friday, April 7, 2017, the Physician-Focused Payment Model Technical Advisory Committee (PTAC) released an updated agenda for their April 2017 meeting. Originally four proposals were scheduled to be presented for public comment and final vote. The Comprehensive Colonoscopy Advanced Alternative Payment Model for Colorectal Cancer Screening, Diagnosis and Surveillance proposal has been withdrawn. PTAC…

ORIGINAL ANALYSIS

Payment Innovation: Quality Payment Program

Registration Open for MIPS Group Web Interface and CAHPS Reporting

Groups utilizing the CMS web interface and/or CAHPS reporting must register by June 30, 2017

ORIGINAL ANALYSIS

Payment Innovation: Quality Payment Program

CMS Announces April 5th Listening Session on Cost Measure Development

CMS is hosting a listening session on episode-based cost measure development for the Merit-based Incentive Payment System (MIPS) from 12:00 – 1:30 PM ET on April 5, 2017. During this listening session, CMS will provide more information on cost measures and the role stakeholders play in cost measure development.

ORIGINAL ANALYSIS

Payment Innovation: Quality Payment Program

CMS Hosts Advancing Care Information Webinar on April 4th

On Tuesday, April 4 at 1:00 PM ET, the Centers for Medicare & Medicaid Services (CMS) will host a webinar to provide more information on the Advancing Care Information performance category of the Merit-based Incentive Payment System (MIPS). During the webinar, CMS will highlight requirements for the 2017 Advancing Care Information performance category and participants…

ORIGINAL ANALYSIS

Payment Innovation: Regulation

2018 Quality Payment Program Proposed Rule Lands at OMB

This week the Centers for Medicare Medicaid Services (CMS) sent the 2018 Quality Payment Program (QPP) Proposed Rule (CMS-5522-P) to the Office of Management of Budget (OMB) for review. Established through the Medicare Access and CHIP Reauthorization Act (MACRA), the QPP established two tracks for Medicare physician payment: the Merit-Based Incentive Payment System (MIPS) and…

ORIGINAL ANALYSIS

Payment Innovation: Quality Payment Program

Prior to Implementation of MACRA, Physician Groups Request CMS to Address Administrative Burden of Legacy Physician Quality Programs for 2018

On March 21, 2017, the American Medical Association and 86 state and specialty medical societies submitted a letter requesting the Centers for Medicare and Medicaid Services (CMS) reduce the administrative burden and provide for hardship exemptions for the three legacy physician quality programs: Meaningful Use (MU), Physician Quality Reporting System (PQRS) and the Value-based Modifier (VM) in…

ORIGINAL ANALYSIS

Payment Innovation: Quality Payment Program

CMS Requests Comments on Draft Episode Groups, Trigger Codes and Proposed Framework for Cost Measures

CMS is accepting comments until April 24, 2017, on draft episode groups, trigger codes and a proposed framework for cost measures. The Merit-based Incentive Payment System (MIPS) measures clinicians’ performance in four areas: quality, clinical practice improvement activities, advancing care information (i.e., meaningful use of certified electronic health record technology or CEHRT), and cost (i.e.,…

ORIGINAL ANALYSIS

Payment Innovation: Quality Payment Program

CMS Seeks Volunteers for QPP Website Testing

CMS is seeking volunteers to test the Quality Payment Program website. CMS is seeking comments on the functionality of the current website as well as recommendations for future improvements. Interested Medicare clinicians, practice managers, administrative staff and EHR and registry vendors are encouraged to volunteer.

ORIGINAL ANALYSIS

Payment Innovation: Quality Payment Program

MedPAC Considers How to Reduce Burden of MIPS and Encourage Participation in Advanced APMs

On March 2, 2017 the Medicare Payment Advisory Commission (MedPAC) met in Washington DC and discussed alternatives to the Merit-based Incentive Payment System (MIPS), Advanced Alternative Payment Models (APMs) and ways to increase support for primary care.

ORIGINAL ANALYSIS

Payment Innovation: Innovation Center

CMS Hosts Webinar on ACO Track 1+ Model

Registration is open for a webinar hosted by the Centers for Medicare and Medicaid Services (CMS) on the ACO Track 1+ model.  Previously, CMS announced that beginning in 2018 the ACO Track 1+ model would be an option under the Advanced APM track of the Quality Payment Program.

ORIGINAL ANALYSIS

Payment Innovation: Quality Payment Program

CMS Posts Updated eCQM Table

The Centers for Medicare and Medicaid (CMS) recently posted an updated electronic clinical quality measures (eCQM) table on its website. In an effort to improve alignment of the eCQMs with current quality initiatives, this update removes the previous meaningful use domains and now aligns the measures with the domains listed in the Merit-based Incentive Payment System and…

ORIGINAL ANALYSIS

Payment Innovation: Quality Payment Program

MedPAC Will Discuss MIPS and Advanced APMs During March 2 Meeting

The Medicare Payment Advisory Commission (MedPAC) has placed discussion of the Merit-based Incentive Payment System (MIPS) and Advanced Alternative Payment Models (APMs) on the agenda for their March 2 meeting scheduled to be held in Washington, DC.

ORIGINAL ANALYSIS

Payment Innovation: Innovation Center

CMS Releases RFI on Pediatric APMS

On Monday, February 27, 2017, CMS released a Request for Information (RFI) to collect stakeholder input on the development of pediatric Alternative Payment Models (APMS). The focus of this RFI is on the improvement of quality and reduction in cost for the care of children enrolled in Medicaid and the Children’s Health Insurance Plan (CHIP).

ORIGINAL ANALYSIS

Payment Innovation: PTAC

PTAC Announces Public Meetings for March and April 2017

The Physician-Focused Payment Model Technical Advisory Committee (PTAC) recently announced two public meetings scheduled for March 13-14 and April 10-11. Registration information is available here.

ORIGINAL ANALYSIS

Payment Innovation: Quality Payment Program

CMS Opens Call for Measures and Activities

The Centers for Medicare and Medicaid Services (CMS) opened the submission period of the Annual Call for Measures and Activities for the Merit-Based Incentive Payment System (MIPS) track of the Quality Payment Program.

ORIGINAL ANALYSIS

Payment Innovation: Quality Payment Program

CMS Posts Numerous MACRA Resources on QPP Website

CMS recently posted a variety of MACRA-related educational resources for clinicians, registries, qualified clinical data registries (QCDRs) and EHR vendors to the Quality Payment Program website.

ORIGINAL ANALYSIS

Payment Innovation: Quality Payment Program

CMS Hosts Call: Transitioning from PQRS to MIPS

CMS is hosting a conference call on Tuesday, January 24 from 2:00 to 3:00 PM ET on how to complete the final reporting period for the legacy Medicare quality reporting programs and transitioning to the Merit-based Incentive Payment System (MIPS).

ORIGINAL ANALYSIS

Payment Innovation: Quality Payment Program

CMS Accepting Applications for CPIA Measurement Study

Participants receive full credit for the Improvements Activities Performance Category

ORIGINAL ANALYSIS

Payment Innovation: Regulation

CMS Finalizes Policies for New Mandatory Cardiac and Orthopedic Models, Adjustments to CJR; Previews Details of Medicare Track One Plus ACO Model

On Tuesday, December 20, 2016 the Centers for Medicare and Medicaid Services (CMS) finalized several new Innovation center models expanding the agency’s footprint in the value based payment model space.

ORIGINAL ANALYSIS

Payment Innovation: Quality Payment Program

OIG Releases Report on MACRA Early Implementation Efforts

The Office of the Inspector General (OIG) recently released a report on the results from an early implementation review of the Medicare agency’s management of the Quality Payment Program (QPP).

ORIGINAL ANALYSIS

Payment Innovation: Regulation

Lost Your Bearings in the MACRA Final Rule? M+ Table of Contents Will Help You Find Your Way

Both a standalone TOC and TOC hyperlinked to the Official Federal Register Published Final Rule are available.

ORIGINAL ANALYSIS

Payment Innovation: Quality Payment Program

CMS Posts Slide Decks on MACRA Final Rule

The Centers for Medicare & Medicaid Services (CMS) recently posted a number of slide decks and a webinar recording on the Medicare Access and CHIP Reauthorization Act (MACRA) of 2015 final rule.

ORIGINAL ANALYSIS

Payment Innovation: Quality Payment Program

CMS Announces Reduced Medical Review Pilot Program for Providers Aligned with Certain Advanced APMs

On October 13, 2016, the Centers for Medicare & Medicaid Services (CMS) announced an 18-month pilot program to reduce the burden of medical record review of clinicians participating in certain Advanced Alternative Payment Models (APMs). CMS uses contractors to review payments and claims for accuracy. Despite the administrative burden on both the agency and providers…

ORIGINAL ANALYSIS

Payment Innovation: PTAC

PTAC Accepts Comments on Draft RFP and PFPM-related Guidance Until October 14

The Physician-Focused Technical Advisory Committee (PTAC) is accepting comments until October 14, 2016, on a draft Request for Proposals (RFP) for physician-focused payment models (PFPMs) and draft guidance on characteristic of payment models likely to be recommended by PTAC.

ORIGINAL ANALYSIS

Payment Innovation: PTAC

PTAC Anticipates Accepting PFPM Proposals Beginning December 1

The Physician Focused Technical Advisory Committee (PTAC) announced during a recent public meeting that they anticipate accepting proposals for Physician-Focused Payment Models (PFPMs) beginning December 1, 2016. Since it is anticipated that there will be few Advanced Alternative Payment Model (APM) options for physician specialists, PTAC and the development of PFPMs are considered critical in…

ORIGINAL ANALYSIS

Payment Innovation: Quality Payment Program

CMS Releases MACRA Participation Options for 2017

On September 8, 2016, the Centers for Medicare & Medicaid Services (CMS) announced updated 2017 MACRA participation options via the CMS blog.

ORIGINAL ANALYSIS

Payment Innovation: Quality Payment Program

Nominations Due on September 15 for MACRA CMS Quality Measure Development Plan Technical Expert Panel

CMS is currently soliciting nominations for technical expert panel members to support the CMS Quality Measure Development Plan (MDP) project.  The MDP is mandated by the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA), which also requires the preparation of an annual report on the development of measures for the CMS Quality Payment Program.

ORIGINAL ANALYSIS

Payment Innovation: PTAC

PTAC Public Meeting Announced for September 16

The Physician-Focused Payment Model Technical Advisory Committee (PTAC) announced a public meeting for September 16, 2016. Registration information is available here. While a formal agenda has not yet been released, it is anticipated that PTAC will discuss its revised Proposal Review Process document which was recently posted on their website along with a document summarizing their response to public…

ORIGINAL ANALYSIS

Payment Innovation: Original Analysis

MACRA: Building a Winning Strategy Webcast

On August 10, 2016, McDermott+Consulting and McDermott, Will & Emery hosted a webcast on the impact of the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) statute in reshaping the physician services market and strategic considerations for health systems.

ORIGINAL ANALYSIS

Payment Innovation: Regulation

CMS Drops 2018 MACRA Proposed Rule – Proposes Continuing Flexibilities for Year 2

On July 25, 2016 the Centers for Medicare and Medicaid Services (CMS) released a Proposed Rule for a new mandatory bundled payment model for cardiac care, an expansion of the Comprehensive Care for Joint Replacement (CJR) model and a Cardiac Rehabilitation (CR) incentive payment model. CMS also indicated that these proposed bundled payment models could…

ORIGINAL ANALYSIS

Payment Innovation: Quality Payment Program

CMS Posts New MACRA Slide Decks

The Centers for Medicare & Medicaid Services (CMS) recently posted new MACRA slide decks on the Quality and Resource Use performance categories. These are the latest additions to a series of presentations CMS is releasing on the Medicare Access and CHIP Reauthorization Act (MACRA) of 2015. Both of these presentations go into greater detail, than…

ORIGINAL ANALYSIS

Payment Innovation: Quality Payment Program

CMS Announces Funding Opportunity to Support Small Practice Transformation

On Friday, June 10, 2016 the Centers for Medicare & Medicaid Services (CMS) announced funding for the Support and Alignment Networks under the Transforming Clinical Practice Initiative (TCPI). Up to $10 million over the next three years is available to leverage primary and specialist care transformation work and learning in the support of the adoption of…

ORIGINAL ANALYSIS

Payment Innovation: Quality Payment Program

Joint Quality Payment Program Task Force Met on Tuesday, May 24 – Next Meeting Scheduled for Friday, May 27

On May 24, 2016, the Joint Quality Payment Program Task Force, an advisory board of the Office of the National Coordinator for Health Information Technology (ONC), met to review the Task Force charge and work plan. The Task Force is charged with reviewing the MACRA Proposed Rule with a specific focus on how the use…

ORIGINAL ANALYSIS

Payment Innovation: Quality Payment Program

Andy Slavitt Provides Testimony at MACRA Hearing

On May 11, 2016 Andrew Slavitt, Acting Administrator of the Centers for Medicare and Medicaid Services (CMS) provided testimony at a hearing on the implementation of the Medicare Access and CHIP Reauthorization Act (MACRA) of 2015 held by the Subcommittee on Health of the House Ways and Means Committee.

ORIGINAL ANALYSIS

Payment Innovation: Quality Payment Program

CMS Posts Slide Deck on Advancing Care Information MIPS Performance Category

The newest addition to the catalog of Medicare Access and CHIP Reauthorization Act (MACRA) of 2015 educational slide decks is on the Advancing Care Information (ACI) performance category of the Merit-Based Incentive Payment System (MIPS). The ACI performance category is designed to meet many of the same objectives of the current Meaningful Use Program.

ORIGINAL ANALYSIS

Payment Innovation: Quality Payment Program

CMS Solicits Comments on Episode Groups

CMS posted for comment episode groups that are being developed to help measure resource use under the MACRA Merit-Based Incentive Payment System (MIPS) and the Advanced Payment Model program.

ORIGINAL ANALYSIS

Payment Innovation: Quality Payment Program

CMS Posts Slide Decks from Recent MACRA Webinars

On May 5, 2016 the Centers for Medicare and Medicaid Services (CMS) posted slide decks from recent webinars on the Medicare Access and Children’s Health Insurance Program (CHIP) Reauthorization Act (MACRA) of 2015 Proposed Rule.

ORIGINAL ANALYSIS

Payment Innovation: Quality Payment Program

CMS Announces Competition for the Development of a MIPS Mobile Platform to Support Provider Education and Outreach

On May 2, 2016 the Centers for Medicare and Medicaid Services (CMS) announced a competition for the development of a Merit-based Incentive Payment System (MIPS) Mobile Platform to support provider education and outreach.

ORIGINAL ANALYSIS

Payment Innovation: Quality Payment Program

MACRA Update: Physician Focused Payment Model TAC Conducts First Meeting

Tension between Need for Specialty Focused Versus More General Models Emerged from Public Comments

ORIGINAL ANALYSIS

Payment Innovation: Quality Payment Program

MACRA Physician-Focused Payment Model Technical Advisory Committee Meets on Feb 1, 2016

The Physician-Focused Payment Model Technical Advisory Committee will hold its first public meeting on February 1, 2016 in Washington, DC. More information on the meeting, including registration information, is available here.

ORIGINAL ANALYSIS

Payment Innovation: Other

LAN Releases Final APM White Paper

On January 12, 2016 the Health Care Payment Learning & Action Network (LAN) released the final Alternative Payment Model (APM) Framework White Paper. The paper defines payment model categories and establishes a common framework and a set of conventions for measuring progress in the adoption of APMs.

ORIGINAL ANALYSIS

Payment Innovation: PTAC

GAO Makes Appointments to New HHS Advisory Committee on Physician Payment Models

On October 9, 2015 the Government Accountability Office (GAO) announced the first appointments to the Physician-Focused Payment Model Technical Advisory Committee. The Medicare Access and CHIP Reauthorization Act of 2015 established this committee to provide comments and recommendations to the Secretary of Health and Human Services on physician payment models, giving the Comptroller General responsibility…

ORIGINAL ANALYSIS

Payment Innovation: Original Analysis

Eric Zimmerman Discusses Impact of MIPS

Eric Zimmerman discusses the impact the new Merit-Based Incentive Payment System (MIPS) will have on smaller practices: ” the MIPS program, in combination with the incentives for providers to participate in APMs, has the potential to profoundly increase the administrative burden for practicing physicians.”

ORIGINAL ANALYSIS

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