Tag: Merit-Based Incentive Payment System

Medicare-Physician-Fee-Schedule-2023

New Rule on Medicare Physician Fee Schedule for the CY 2023

In addition to physician reimbursement cuts, CMS included changes to the Quality Payment Program in the CY 2023 Medicare Physician Fee Schedule proposed rule. In its recently released calendar year (CY) 2023 Medicare Physician Fee Schedule (PFS) proposed rule, CMS proposed Quality Payment Program (QPP) changes to the Merit-based Incentive Payment System (MIPS) and Advanced […]
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Top Challenges of the Merit-Based Incentive Payment System

The Government Accountability Office (GAO) analyzed performance data from providers who participated in the Merit-Based Incentive Payment System (MIPS) between 2017 and 2019 and found that some providers experienced MIPS challenges. Under MIPS, CMS monitors provider performance in four different categories: quality, improvement activities, promoting interoperability, and cost. The providers receive scores in each category, […]
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AHA Pens Oppositions to 2022 Physician Fee Schedule Proposed Rule

The organization is concerned about policies in the 2022 Physician Fee Schedule proposed rule, ranging from telehealth worries to apprehension about MIPS. The AHA agreed with certain aspects of the rule but also voiced various problems and recommendations for CMS to consider. The AHA opposed several telehealth policies that CMS included in the rule. The […]
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Key Quality Payment Program Changes in 2022 PFS Proposed Rule

CMS introduced the first seven MIPS value pathways and other updates to the Quality Payment Program as part of the Medicare Physician Fee Schedule proposed rule. If finalized, the Quality Payment Program (QPP) will undergo significant policy changes under the Medicare Physician Fee Schedule (PFS) proposed rule. Most notably, the rule introduced the first seven […]
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MIPS Proving a Financial Boon for System-Affiliated Doctors

Doctors looking to earn more under Medicare’s Merit-based Incentive Payment System (MIPS) would likely benefit from working in a practice affiliated with a hospital system. A recently-published study in JAMA finds that doctors in system-affiliated practices earned substantially higher MIPS scores in 2019 than those in independent practice, and were thus more likely to receive upward payment adjustments and […]
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Clinicians Serving Socially At-Risk at a Disadvantage Under MIPS

Clinicians who served more patients with social risk factors such as low income performed worse in the Merit-Based Incentive Payment System’s inaugural payment year, and therefore, received unfavorable value-based reimbursement, according to a new study. The study recently published in Health Affairs found that out of 510,020 clinicians participating in the Merit-Based Incentive Payment System (MIPS) in 2019, […]
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A View into Proposed Medicare PFS and Policy Changes for 2021

The Centers for Medicare & Medicaid Services (CMS) in the past week has proposed Medicare payment rules for outpatient services and physicians for 2021 and finalized payment rules for inpatient rehabilitation facilities (IRFs) and psychiatric facilities. Looking specifically at the 2021 Physician Fee Schedule (PFS) proposed rule, scheduled to be published Aug. 17, it had […]
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Providers Support Value in Health Care Act that Amends MACRA Payment Model

Among other provisions, the bill extends the 5% advanced APM bonus for an additional six years and modifies thresholds to achieve the bonus. Thirteen national provider groups support the newly-introduced House bill, the Value in Health Care Act of 2020, a bipartisan effort that proposes to make changes to the Medicare Access and CHIP Reauthorization Act (MACRA) […]
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Coronavirus: CMS Urges Use Of Quality Payment Program In Clinical Trials

The Centers for Medicare & Medicaid Services (CMS) is pushing clinicians to participate in the Quality Payment Program to contribute scientific research and evidence to aid in the fight against the COVID-19 coronavirus pandemic. According to a news release, those who participate in COVID-19 clinical trials and report information may now earn credit in the Merit-based […]
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Exploring MIPS 2020: Keys for Physicians To Know

In August, the Centers for Medicare & Medicaid Services (CMS) announced proposed modifications to the Merit-Based Incentive Payment System (MIPS). As physician practices work to understand what’s changed, there are certain aspects of which they need to be aware. The following sections provide key takeaways and offer strategies for meeting the coming year’s requirements. Threshold […]
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