Roji Intel Blog

Thomas Dent, M.D. 0
0
Population HealthPQRS Reporting
December 2, 2014

No More Blame Game: How to Use Patient Outcomes Measurement to Boost Quality and Provider Performance

Fair or not, if your patients don’t do well, your physicians can be tagged as poorly performing providers. But there are ways to change the dynamic for your organization by effectively using patient outcomes measurement to structure and drive a quality program that benefits both patients and providers. Tracking the health and status of patients—“how patients do”—is the Holy Grail of quality measurement. Despite the fact that it is very difficult to identify a direct cause and effect between provider action and patient outcomes, quality programs are shifting the emphasis to patient outcomes and attributing performance to physicians. This is…
Read More
Theresa Hush 0
0
Population HealthPQRS ReportingValue-Based Payment Modifier
November 18, 2014

PQRS 2015: How Your Practice and Patients Can Benefit from New Population Health Measures

Good news for providers who have criticized PQRS as mundane and want to improve assessment of patient outcomes and reduce gaps in care: Medicare’s PQRS 2015 Rule is shifting away from rewarding fragmented quality services and toward population health. With the expansion of the related Value-Based Payment Modifier (VBPM), every group can turn population health into higher Medicare revenues, so long as you have strong, patient-centric processes—and data capture. If you don’t, you may suffer penalties. What’s a Cross-Cutting Measure and How Does It Work? CMS has established a set of Cross-Cutting Measures to provide a broader evaluation of care…
Read More
Theresa Hush 0
0
PQRS ReportingQualified Clinical Data Registry ReportingValue-Based Payment Modifier
November 11, 2014

Specialists at Risk: How To Navigate Hazards in Medicare’s Value-Based Purchasing Programs

Heads up, specialty providers. The future of your practice may depend on three key components in Medicare’s Value-Based Purchasing program. Especially if you work in an independent practice with a higher proportion of Medicare patients than many primary care physicians, your income and practice survival are at risk if you don’t understand implications of the new Rule for 2015. This is certain: You must manage the new environment to avoid penalties and losses under these programs. Most important are PQRS 2015, Value-Based Payment Modifier (VBPM) and ACO Participation. That’s the foundation; with requirements getting tougher every year, you need to…
Read More
Dave Halpert 0
0
PQRS ReportingValue-Based Payment Modifier
November 6, 2014

Final PQRS 2015 Reporting Rule: Higher Penalties and Tougher Requirements

Looking for a good bedtime read? CMS has finalized its 1200-page Medicare Physician Payment System rule for 2015. While the full version is a sure cure for insomnia, buried within are two areas worth your attention: 2015 PQRS Reporting, and Medicare’s Value-Based Payment Modifier (VBPM). Central to Medicare’s value-based health care efforts, both impose stiffer penalty risks for physician groups in 2015. Here are key rule highlights for these two programs, modified slightly from the proposed rule.   Higher Penalties for PQRS Non-Reporting Failure to report PQRS triggers two penalties: a PQRS non-reporting penalty of 2 percent, plus a VBPM non-reporting penalty…
Read More
Thomas Dent, M.D. 0
0
PQRS Reporting
October 1, 2014

Is Your PQRS Program “Old School”? Shift Your Focus to Competitive Performance in 5 Key Steps

It used to be that CMS rewarded providers almost exclusively on the reporting of PQRS quality measures. Providers received a Medicare bonus even if they did not meet a measure’s performance. Medicare still requires PQRS reporting to avoid penalties and receive a bonus, but CMS has now made it the first step in a larger quality measurement process. Performance on measures is now critically important for practices or groups falling under Value-Based Payment Modifier (VBPM) quality tiering or who participate in an ACO. This includes the vast majority of all physicians. Bottom line: It’s no longer enough simply to report…
Read More
Theresa Hush 0
0
PQRS ReportingQualified Clinical Data Registry Reporting
September 25, 2014

How to Integrate Strategic Quality Initiatives with PQRS Reporting: The QCDR Opportunity

For 2014 and beyond, CMS has created a new mechanism for PQRS reporting—the Qualified Clinical Data Registry. QCDR reporting requirements are the same as for a traditional Registry utilizing individual measures: A provider must report on at least nine measures. These measures must represent at least three National Quality and Strategy (NQS) Domains. Each of the nine measures must be completed for at least 50 percent of eligible patients or cases. However, a QCDR has features that can bring more to PQRS performance and reporting. QCDRs are designed to foster improvement in the quality of care provided to patients.  A…
Read More
Theresa Hush 0
0
PQRS Reporting
September 15, 2014

Still Not Sure of Your PQRS 2014 Strategy? Delays Will Cost You

If your organization is just beginning to think about PQRS reporting for 2014, beware. End-of-year data collection is no longer enough to meet PQRS requirements. That’s because PQRS is no longer a quality “reporting” program; it’s now all about performance. In fact, waiting to determine your 2014 PQRS strategy until the last minute is actually very risky and could jeopardize both performance and future revenue. Although reporting through a qualified Registry extends your deadline (for 2014, CMS will not close its portal until March 31, 2015), the new Value-Based Payment Modifier (VBPM) requires more lead time to demonstrate good results.…
Read More