Tag Archives | MACRA

From Bundled Payment Reform to MACRA: Pick Your Poison

MACRA continues to be a subject that perplexes providers even as the program evolves. It has been recently confirmed that the Comprehensive Care for Joint Replacement (CJR) bundled payment has been cut from 67 to 34 percent in the program, and the carding rehabilitation incentive with bundled payments has been cancelled. The new political leadership […]

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Outpatient CDI: Is “Outpatient” Out? Part I

There is a great push within the healthcare industry to move clinical documentation integrity (CDI) into the outpatient arena. People refer to this as “outpatient CDI,” but I think this is a misnomer. If you plan on stationing CDI specialists (CDISs) in physician offices, that could be construed as “outpatient CDI,” but I believe the […]

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CMS Exempts Two Thirds of Clinicians From MIPS

The Centers for Medicare & Medicaid Services (CMS) has exempted about two thirds of physicians and other clinicians who provide care to Medicare beneficiaries from the Merit-based Incentive Payment System (MIPS), a pay-for-performance scheme that will determine part of physicians’ Medicare payments, starting in 2019. A CMS spokesman told Medscape Medical News, “CMS mailed approximately […]

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MIPS Reporting: MACRA Final Rule Lists Available Quality Measures for MIPS reporting

MIPS Eligible Clinicians can opt to report as individuals or as a group. A group is defined by the Tax Identification Number (TIN). If you choose this option, the group will be assessed as a group practice across all four MIPS performance categories. Eligible clinicians can take their reporting scores with them if they should […]

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Episodes of Care: The Future of Healthcare Payment?

The financing of healthcare is rapidly changing in this country. The Centers for Medicare and Medicaid Services (CMS) has introduced a wide array of value-based alternative payment models including bundled payments and shared savings through Accountable Care Organizations and Pay for Performance programs. The passage of the Medicare Access and CHIP Reauthorization Act (MACRA) includes […]

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Why It’s Essential That MACRA’s Start Be Delayed

This week at a hearing before the Senate Finance Committee, providers heard some comforting statements from Senate leaders and a key official from the Centers for Medicare and Medicaid Services. At the hearing, Andy Slavitt, acting administrator for CMS, said his agency was looking for ways to be flexible with the approach for enacting the […]

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Senate Passes Medicare Access and CHIP Reauthorization Act 92 to 8 – Avoids Payment Cuts

Closing in on two hours before the midnight deadline, the U.S. Senate on Tuesday April 14th, 2015 passed the bill in a vote of 92 to 8 to permanently end the sustainable growth rate (SGR) formula that threatened to cut physician Medicare reimbursement by 21 percent.

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