Many people have asked me to review the Quality Payment Program final rule, released on October 14, 2016. Several summaries have already been written but your best bet is to rely on the CMS Quality Payment Program website at https://qpp.cms.gov. Yes, the rule is still complex - over 2400 pages, of which more than 50% is the mandated response to comments made on the proposed rule. The good news is that CMS has been very responsive to feedback, creating a transition plan for adoption, reducing the number of criteria and extending the timeline which enables iterative learning before large scale implementation. Under the Quality Payment Program, clinicians have two approaches to choose from for reimbursement: the Merit-based Incentive program (MIPS) and Advanced Alternative Payment Models (APMs)...
Physician Value-based Payment Modifier (VM)
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Halamaka Takes a Deep Dive on the MACRA NPRM
As promised last week, I’ve read and taken detailed notes on the entire 962 page MACRA notice of proposed rulemaking (NPRM) so that you will not have to. Although this post is long, it is better than the 20 hours of reading I had to do! Here is everything you need to know from an IT perspective about the MACRA NPRM...What is the MACRA NPRM trying to achieve with regard to healthcare IT? The MACRA NPRM proposes to consolidate components of three existing programs, the Physician Quality Reporting System (PQRS), the Physician Value-based Payment Modifier (VM), and the Medicare Electronic Health Record (EHR) Incentive Program for eligible professionals (EPs), creating a single set of reporting requirements. The rule would sunset payment adjustments under the current PQRS, VM, and the Medicare EHR Incentive Program for eligible professionals...
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The Quality Payment Program Final Rule
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