Tag: Merit-Based Incentive Payment System

MIPS performance disparities

MIPS Performance Disparities: How Individual Radiologists Are Impacted

A recent study published in the Journal of the American College of Radiology reveals stark MIPS performance disparities, with individual radiologists facing significant disadvantages compared to those participating in group reporting or Advanced Payment Models (APMs) within the Centers for Medicare & Medicaid Services (CMS) Merit-Based Incentive Payment System (MIPS). The research, analyzing data from […]
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Medicare Payment Cuts Hit Physicians: 2.93% Reduction in 2025

Medicare Payment Cuts Hit Physicians: 2.93% Reduction in 2025

Medicare payment cut: The Centers for Medicare & Medicaid Services (CMS) has released its proposed rule for the 2025 Medicare Physician Fee Schedule (MPFS), which includes a 2.93% average payment rate reduction for physicians. This comes despite the agency’s stated commitment to advancing health equity and supporting whole-person care through initiatives like strengthening primary care […]
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Final Rule for Streamlining Prior Authorization Processes Unveiled

Final Rule for Streamlining Prior Authorization Processes Unveiled

In an effort to streamline prior authorization processes, provider bunches, including the American Medical Association (AMA) and the Medical Group Management Association (MGMA), have asserted that the ultimate goal of the new regulations will assist in facilitating a more efficient and effective prior authorization workflow. Provider bunches are commending CMS for finalizing understanding data-sharing approaches […]
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3.36% Cut in The Proposed 2024 Medicare Physician Pay Schedule

3.36% Cut in The Proposed 2024 Medicare Physician Pay Schedule

What’s the news: The AMA is emphatically stating that the proposed 3.36% reduction in the 2024 Medicare physician payment schedule is ill-advised, posing a threat to the accessibility of high-quality physician care for the 50 million plus elderly individuals enrolled in Medicare. The AMA President emphasized that with escalating costs associated with medical practice; another […]
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New Rule on Medicare Physician Fee Schedule for the CY 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

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 […]
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AHA Pens Oppositions to 2022 Physician Fee Schedule Proposed Rule

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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MIPS Proving a Financial Boon for System-Affiliated Doctors

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 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 […]
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