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…
The past year saw multiple developments that could affect payment reform—a new administration was getting up to speed, the Affordable Care Act (ACA) was debated and its implementation modified through legislative and regulatory changes, and questions were raised about the future of alternative payment models. Despite this, implementation of the Medicare Access and CHIP Reauthorization…
In a letter addressed to doctors, CMS Administrator Seema Verma reaffirmed the federal agency’s commitment to “turning the tide” of rising rates of physician burnout and reducing clinical documentation requirements to cut provider burden. “From reporting on measures that demand that you follow complicated and redundant processes, to documenting lines of text that add no…
Value-based care is touted as a way of incentivizing providers to achieve the triple aim: delivering high quality care, improving population health management, and lowering healthcare costs. While shifting from a fee-for-service model to a value-based care system has the potential to improve patient health outcomes and save healthcare organizations money, the transition from the…
An avalanche of new pay proposals from the CMS seeks to reduce provider burden, so much so that it could undermine efforts to shift Medicare to a value-based system, doctors warned. The agency released a 1,400-page proposed rule July 12 that for the first time combined the annual physician fee schedule and the Medicare Quality…
CMS recently announced that it advanced a demonstration that would waive Merit-Based Incentive Payment System (MIPS) requirements for eligible clinicians participating in at-risk Medicare Advantage plans. If approved, the Medicare Advantage Qualifying Payment Arrangement Incentive (MAQI) demonstration would apply to eligible clinicians sufficiently involved in Medicare Advantage plans that resemble Advanced Alternative Payment Models (Advanced…
If you’re scratching your head about the direction of Value-Based Health Care (VBHC) in Medicare, you’re not alone. The current mix includes a swirl of separate initiatives, some new and others recently re-labeled. As CMS pushes toward VBHC, providers may feel confused and frustrated as concepts emerge that will affect multiple programs. Within the last…
The Medicare Payment Advisory Commission has released its semiannual report on Medicare payment policy to Congress, which includes a recommendation to axe the Merit-based Incentive Payment System. MedPAC said it decided MIPS should be eliminated after a two-year deliberative process. “We first examined options for improving MIPS as it was implemented, and we provided constructive…