Tag: Merit-Based Incentive Payment System

: Final Rule for Streamlining Prior Authorization Processes

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 Threatens Medicare Physician Care Access in 2024

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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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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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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