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MIPS/MACRA

Reinventing Utilization Management to Bring Value to the Point of Care

February 21, 2018  |  Nilo Mehrabian Vice President, Product Management, Decision Support, Change Healthcare
article
How an automated exception-based approach can make UM more efficient and effective.

CMS’ MSSP Proposed Changes Slammed by Leading ACO Organization

August 10, 2018  |  Rajiv Leventhal
article
The National Association of ACOs called CMS’ proposals to redo the MSSP “misguided,” noting that the changes, if finalized, “will upend the ACO movement by creating havoc with a significant overhaul introducing many untested and troubling policies.”

In Virginia, Centra Health Surges Ahead in its IT-Based Push to Value

July 25, 2018  |  Rajiv Leventhal
article
Two of the health system’s executive leaders recently spoke with Healthcare Informatics about Centra Health’s value-based care journey and how IT is playing a key role.

Healthcare Leaders React to CMS’ 2019 QPP Proposed Rule and E&M Coding Changes

July 18, 2018  |  Heather Landi
article
Some health IT industry groups have voiced concerns that the CMS proposals, specifically in its proposed rule for the third year of the Quality Payment Program, will undermine efforts to move Medicare provider payment to value.

PODCAST: Policy Experts Dissect CMS’ “Modernizing Medicare” Proposed Rule

July 16, 2018  |  Rajiv Leventhal
article
Jeff Smith, vice president of public policy at AMIA, and Tom Lee, Ph.D., CEO and founder of Chicago based SA Ignite, a company that helps healthcare organizations with value-based reporting, weigh in on the different components of CMS' proposed rule

BREAKING: CMS Proposes Dramatic Changes with Aim to “Modernize Medicare and Restore Doctor-Patient Relationships”

July 12, 2018  |  Rajiv Leventhal
article
CMS today proposed changes that the agency believes will “fundamentally improve the nation’s healthcare system and help restore the doctor-patient relationship by empowering clinicians to use their EHRs to document clinically meaningful information.”

New Research Reveals MIPS Confusion Among Physicians

July 10, 2018  |  Rajiv Leventhal
article
A survey of internal medicine physicians has revealed low levels of familiarity with the Merit-based Incentive Payment System (MIPS), with some respondents also believing that MIPS requirements could lead to unintended consequences.

CMS Offers Demonstration to Waive MIPS Requirements for Some Clinicians

July 2, 2018  |  Rajiv Leventhal
news
CMS is advancing the Medicare Advantage Qualifying Payment Arrangement Incentive Demonstration, which, when approved and adopted, would waive Merit-Based Incentive Payment System (MIPS) requirements for some clinicians.

CMS Hits MIPS Participation Goal for Year One

June 4, 2018  |  Rajiv Leventhal
news
According to CMS Administrator Seema Verma, 91 percent of all Merit-based Incentive Payment System (MIPS)-eligible clinicians participated in the first year of the Quality Payment Program (QPP), exceeding the agency’s internal goal.

In the New Healthcare, Payers and Providers Look to Redefine Quality

May 30, 2018  |  Rajiv Leventhal
article
The pressure is mounting on providers to deliver better outcomes. But moving forward, federal leaders must strike a balance between being able to measure outcomes while not overburdening patient caregivers even more.

Karen DeSalvo Joins MedPAC as New Member

May 30, 2018  |  Rajiv Leventhal
news
Five new members have been added to the Medicare Payment Advisory Commission (MedPAC), including former National Coordinator for Health IT, Karen DeSalvo, M.D., the Government Accountability Office (GAO) announced.

A Cloudy HIT Policy Picture is Beginning to Clear Up

May 29, 2018  |  Rajiv Leventhal
article
At this time last year, healthcare stakeholders were filled with uncertainty, as the future of healthcare policy remained very much in limbo. But in the past several months, an air of stability has presented itself.

At the Philadelphia HIT Summit, One Healthcare Leader Parses the Current State of Payer-Provider Convergence

May 24, 2018  |  Heather Landi
article
As the healthcare industry makes steady progress to value-based care models, one healthcare thought leader sees the commercial payer market playing a larger role, going forward, in pushing provider organizations into value-based care arrangements.

GAO: Just 4 of 37 CMMI Payment Models Have Met Goals around Cost, Quality

May 11, 2018  |  Rajiv Leventhal
news
CMMI, created to test new and cost-effective approaches for delivering and paying for healthcare, has partially met its goals, while just four out of the innovation center’s 37 alternative payment models have actually achieved lower spending and higher quality.

EXCLUSIVE: Substantial ACO Reforms Could be Forthcoming

May 9, 2018  |  Rajiv Leventhal
article
Healthcare Informatics has learned that a CMS rule is forthcoming that could shorten the duration ACOs can stay in one-sided risk models.

An HIT Expert Dives into the Details of CMS’ Proposed Hospital Payment Rule

April 30, 2018  |  Heather Landi
article
With ongoing discussion about the implications of CMS' proposed hospital payment rule, Jeff Smith, vice president of public policy at AMIA, dives into the details of the rule, including how CMS might be raising the interoperability stakes.

Study: System Functionality, Cost and Reporting Requirements Top Reasons for Switching EHRs

April 27, 2018  |  Heather Landi
news
System functionality and cost are the two largest deciding factors in healthcare providers’ decision to switch electronic health record (EHR) vendors, despite the significant cost associated with a new EHR purchase and implementation, according to a study...

Survey: Optimism for Health IT Startups in 2018, Skepticism for Amazon Healthcare Partnership

April 26, 2018  |  Heather Landi
news
Despite all the buzz about new entrants disrupting healthcare, the majority of healthcare stakeholders are dubious about the impact of the Amazon/Berkshire Hathaway/JP Morgan healthcare partnership and believe the effort will face substantial challenges,...

In Proposed MU Rebranding Rule, CMS Raises the Interoperability Stakes

April 26, 2018  |  Rajiv Leventhal and Heather Landi
article
As health IT observers and stakeholders have begun to unpack the 1,883-page CMS proposed rule on meaningful use rebranding, discussion has emerged on if the government will be forcing providers to participate in health information exchange activities.

BREAKING: CMS to Rebrand Meaningful Use Program with New Emphasis on Interoperability, Burden Reduction

April 24, 2018  |  Rajiv Leventhal
article
In a rule released late in the afternoon on April 24, the Centers for Medicare & Medicaid Services (CMS) has made clear its intention to overhaul the meaningful use program.

In Response to Public Comments on CMMI, CMS will Consider Direct Provider Contracting Model

April 24, 2018  |  Rajiv Leventhal
article
CMS has released the comments submitted by healthcare stakeholders in response to the CMS Innovation Center’s new direction RFI, while also announcing that the agency is considering a direct provider contracting model as a result of the feedback.

In Asking for MIPS Flexibilities, Providers Make Legitimate Points

April 23, 2018  |  Rajiv Leventhal
commentary
I was quite intrigued to see the specifics in the recent letter that healthcare provider groups sent CMS about reducing the burden that MIPS requirements have put on clinicians.

Health IT Trade Groups Push CMS for MIPS 90-Day Reporting Period

April 20, 2018  |  Rajiv Leventhal
news
MGMA, AMA and 47 other physician organizations have sent a letter to CMS, calling for the federal agency to reduce the burden of the Merit-based Incentive Payment System (MIPS) by shortening the quality data reporting period from 365 to 90 days.

PODCAST: AMIA’s Jeff Smith on MACRA/MIPS in this Current Moment and What’s Next in HIT Policy

April 19, 2018  |  Rajiv Leventhal
article
On the latest Healthcare Informatics podcast, AMIA’s Jeff Smith gives his thoughts on where things stand with MACRA/MIPS right now, the future of MU, 21st Century Cures tidbits and more.

Survey: Measuring Care Quality a Top HIT Business Objective in 2018

April 16, 2018  |  Heather Landi
news
In a recent survey, health IT leaders identified measuring improvement in patient care quality as one of their top business objectives in 2018, followed by identifying areas of cost reduction.

PODCAST: Micky Tripathi on the Current Health IT Moment—and Exploring the World Ahead

March 20, 2018  |  Rajiv Leventhal
article
On this latest Healthcare Informatics podcast, notable health IT expert Micky Tripathi, Ph.D., talked about what he learned at HIMSS18, KLAS’ report on CommonWell and Carequality, Apple’s health records solution, and much more.

CMS’ Goodrich: More MACRA Relief On the Way

March 19, 2018  |  Rajiv Leventhal
news
CMS said last week that more changes will be coming this year to MACRA—including the alignment of quality measures between hospitals and hospital-employed physicians

Should MIPS be Repealed and Replaced? Several Industry Leaders Weigh in on MedPAC’s Published Proposal

March 19, 2018  |  Heather Landi
article
In its March report to Congress, MedPAC, a policy advisory group, recommends repealing MIPS and replacing it with an alternative model of reimbursement. Several industry thought leaders weigh in on the implications of this recommendation and the future of MIPS.

Michael McCoy, M.D. Shares His Perspectives on the Current Moment in Healthcare IT

March 13, 2018  |  Mark Hagland
article
Following the conclusion of the annual HIMSS Conference, Michael McCoy, M.D. shared with Healthcare Informatics his perspectives on the policy, industry, and technological cross-currents influencing the shift from volume to value in healthcare right now

CMS to Fund Outside Measure Developers for Quality Payment Program

March 7, 2018  |  David Raths
news
The Center for Medicare & Medicaid Services plans to offer up to $30 million in grant funding over three years for the development and expansion of quality measures for use in the Quality Payment Program.

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