Why MIPS EMR Quality Reporting is Risky…

Ok, so you probably guessed I don’t own an EMR (because I am the Principal/CEO of Patient360). However, I have worked on more than nine in the last twenty plus years in medicine both in and outside of hospital systems. The expectations are the same in-house or on your own in the private sector. EMRs should improve care, save money, and help all healthcare providers better communicate with improved data capture.
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M4B in QPP with P360

Most people hate change. It’s hard and often challenging. However, change can also be an opportunistic adventure. At the end of the day, it doesn’t matter whether you like change. In the world of CMS reimbursement, change requires expanded participation… or in 2017, any participation! In short, participate or be penalized. Medicare is giving out “gifts”, and there’s no fat…

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Where’s the EBM behind the QPP and MIPS at CMS?

Evidence based medicine (EBM) has become the mainstay for insurance denials; i.e., the evidence that standard deviations should not be normative and the foundation for why doctors should be automatons in how care is provided before ever thinking about the uniqueness of the patient.  This philosophy is now upon us. Well, the entire Quality Payment Program (QPP) is driving payment…

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Lean into Reporting…It’s not going away, but there are some things you can do now to make it 10 times easier!

Decide how you are going to report NOW for 2017. Start collecting data now! If you know the measures now, it doesn’t matter what system you are on, you can build easy ways to track measures if you know what they are.
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Optimal Measure Selection… To “Cherry Pick” or not

When reimbursement is tied to performance (as it currently is in the Physician Quality Reporting System (PQRS) 2016 reporting season), how do we navigate between what is “right” and what will get us paid?

Registries are in high gear now reviewing boatloads of data as providers finalize their 2016 PQRS submissions. What is the best way to honor the supposed Center for Medicare & Medicaid Services (CMS) “spirit” and intention of the program (to improve quality and patient care) and still receive the maximum reimbursements to which the provider believes s/he is entitled to receive for services rendered? As a qualified registry, that has been vetted by CMS, we walk the fine line everyday of providing a balanced response to this question.

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