CMS is proposing to change quality reporting standards in the Medicare Shared Savings Program and accountable care organizations are pushing back. In the 2021 proposed physician fee schedule rule released Aug. 3, CMS proposed three main changes related to quality: a new mechanism for ACOs to report quality measures, a reduction in the Medicare Shared Savings Program’s…
The newly published 2021 CMS Physician Fee Schedule and Quality Payment Program (QPP) Proposed Rule reflects our harsh reality: Operate under the constraints of the COVID-19 pandemic, while moving toward uniformity and Risk. That tension is palpable in the Proposed Rule’s “push-pull” of CMS trying to continue to advance a Value agenda while stuck in the mud…
The Centers for Medicare & Medicaid Services (CMS) on Aug. 3 released a rule that proposes changes to the Quality Payment Program (QPP) and Medicare Shared Savings Program (MSSP) for 2021. According to federal officials, because providers must stay focused on the COVID-19 pandemic, the number of significant proposed changes to the programs are limited….
As the coronavirus pandemic continues to upend health care in the U.S., pressure has mounted on CMS to adjust its efforts to drive providers to adopt risk. In response, at the end of last week CMS announced a carve-out of COVID-19 patient expenses from certain reporting requirements. In this round, ACOs were on the receiving…
The CMS on Monday encouraged providers to share clinical data in the Quality Payment Program that could help combat the COVID-19 pandemic. The agency will give providers credit in the Merit-Based Incentive Payment System if they participate in a clinical trial that uses a drug or biologic to treat COVID-19 and report the data to…
The current novel coronavirus (COVID-19) pandemic poses a unique challenge to health systems and provider groups participating in accountable care organizations (ACOs) and other alternative payment models. Like all health care institutions, they will face higher patient volumes, higher patient acuity, and shortages of staff, supplies, and space. However, by participating in models that hold…
CMS published 2018 results for the Merit-Based Incentive Payments System program Jan. 6. Five things to know about the results: 1. CMS Administrator Seema Verma said 2018 participation in MIPS, created under the 2015 Medicare Access and CHIP Reauthorization Act, exceeded participation rates in 2017. 2. More clinicians will receive a positive payment adjustment compared…
In July, the Centers for Medicare and Medicaid Services (CMS) proposed a number of changes to its Quality Payment Program and the Merit-based Incentive Payment System (MIPS). Under existing MIPS policy, clinicians are evaluated based on performance in the four separate domains of quality, improvement activities, cost, and promoting interoperability. Stakeholders, including physicians and policy groups, have voiced concerns about…
As the industry transitions from the fee-for-service model to value-based care, many providers are finding themselves struggling to straddle the divide. The shift away from volume has created many new administrative burdens that are handicapping providers’ ability to focus on patient care. In an effort to alleviate these significant provider burdens, CMS recently sent out…
The CMS Proposed Rule for the 2020 Physician Fee Schedule and changes to the Quality Payment Program picks up where the “Pathways to Success” ACO rule left off. This time, the “Pathways” shake-up is aimed squarely at MIPS, in the form of “MIPS Value Pathways.” We’ve described the growing frustration with MIPS, specifically MedPAC’s report to Congress on…