Aug 17, 2017 11:30:00 AM

What Small Medical Groups Need to Know About Virtual Groups - Part 2

By banding together into what CMS has termed “virtual groups,” solo practitioners and small medical groups can take advantage of significant flexibility currently available to help them succeed in the Merit-based Incentive Payment System (MIPS).

In Part 1 of this series, we answered some FAQs about these MIPS virtual groups. In Part 2, we share items to consider before joining a virtual group.

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Topics: APMs, MIPS Healthcare, MACRA Summary

Aug 3, 2017 2:00:00 PM

What Small Medical Groups Need to Know About Virtual Groups for MIPS Reporting – Part 1

Small physician groups and solo practitioners take heart: CMS wants you to be successful in the Merit-based Incentive Payment System (MIPS) without having to merge or be acquired.

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Topics: APMs, MIPS Healthcare

Jul 27, 2017 11:00:00 AM

Is It Time to Transition From CCMAs to APMs?

A Bridge for Healthcare Reform

Over the past decade, clinical co-management arrangements (CCMAs) have risen in popularity as a means to achieve a more integrated care delivery model. CCMAs have often been touted as an interim strategy to bridge hospitals to newer emerging models, but many hospitals have yet to cross that bridge.

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Topics: Healthcare Reform, Payment Models, APMs

Jul 20, 2017 10:00:00 AM

The IRS Isn't the Only One Monitoring Your Exempt Hospital

As discussed in my previous blog post, the IRS is ramping up compliance audits of governmental hospitals who are exempt under 501(c)3. However, the IRS isn’t the only one monitoring your tax-exempt hospital. Other organizations have started policing these requirements.

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Topics: Affordable Care Act Summary, CHNA, Hospital Management

Jul 13, 2017 11:00:00 AM

What’s the Value of Innovation? (Part 2)

The previous installment of this blog series described the CMS Innovation Center and its mission to test innovative payment and delivery models and to implement the MACRA Quality Payment Program (QPP).

The QPP is designed to help achieve HHS’ goal of tying half of Medicare fee-for-service payments to quality or value through Advanced Payment Models (APMs) by 2018. Advanced APMs, one of the two tracks of MACRA, allows physician practices to earn more by assuming some financial risk related to patients’ outcomes. Certain Accountable Care Organizations (ACOs) in the Medicare Shared Savings Program (MSSP), including the new MSSP Track 1+ ACO, qualify as Advanced APMs.

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Topics: Value-Based Care, APMs, Quality Payment Program, MACRA Summary

Jun 26, 2017 10:00:00 AM

Top Takeaways from MACRA Proposed Rule

With the proposed changes to the Quality Payment Program (QPP) released Wednesday, the new administration aims to reduce some administrative complexity and extend the flexibility that CMS provided in the initial year of the program, while incentivizing more providers to move into Alternative Payment Models (APMs).

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Topics: APMs, MACRA Summary

Jun 22, 2017 4:00:00 PM

What’s the Value of Innovation? (Part 1 in a 2-part series)

The Affordable Care Act created the CMS Innovation Center to allow Medicare and Medicaid programs to test innovative payment and delivery models that improve patient care and lower healthcare costs.

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Topics: Affordable Care Act Summary, APMs

Jun 19, 2017 10:30:00 AM

Dual Status Hospitals Beware of IRS Compliance Audits

Is your governmental hospital exempt under Section 501(c)3? If you have a 403(b) plan, the answer is yes; and even if you don’t—you need to check. 

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Topics: CHNA, Health Care Audit

Jun 15, 2017 10:00:00 AM

A Primer on Operationalizing Alternative Payment Models

MACRA’s anticipated future impact on the healthcare industry has many provider organizations contemplating what actions and resources are necessary to participate in alternative payment models (“APMs”). Provider organizations facing the immediate options of getting involved with a CMS or commercial APM have significant operational decisions to make that will impact the future make-up of their organizations. Today we will discuss some of the considerations in preparing for APM participation.

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Topics: APMs, MACRA Summary

Jun 9, 2017 9:00:00 AM

Activity-Based Costing: The Rock Star of Payment Model Reform

Think you can’t afford to invest in a cost-accounting system? The truth is, you can’t afford not to. As Medicare and other payers increasingly tie payments to value, understanding and reducing your cost structure will become an even more urgent priority.

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Topics: Payment Models, Cost Accounting

Jun 1, 2017 11:30:00 AM

CHNAs—Take Them off the Shelf

Community Health Needs Assessments (CHNA), unfortunately for many, are conducted simply to fulfill the Section 501(r) of the Internal Revenue Code which requires a tax-exempt hospital to conduct a CHNA. Also, community health assessment is a prerequisite of public health accreditation under PHAB standards. As we have discussed in a previous blog, a hospital’s CHNA can achieve so much more than fulfilling a regulatory obligation.

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Topics: CHNA

May 25, 2017 10:00:00 AM

A Prescription for Reviving Your Financial Outlook: A Medicare Risk Strategy

Healthcare providers face $42 billion in cuts in 2018 under Medicare’s traditional fee-for-service program. Those payment rate reductions, which were put in place by the Affordable Care Act, are scheduled to cut deeper with each year—from $53 billion in 2019 to $86 billion in 2022.

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Topics: Fee-for-Service, Value-Based Care

May 19, 2017 11:00:00 AM

Lessons Learned From the WannaCry Ransomware Attack

Last week, the WannaCry ransomware attack hit over 150 countries and infected tens of thousands of systems worldwide. Among those victimized were England’s National Health Service, automobile manufacturers, and government systems. The worm’s ominous red ransom screen, informing the user that all files have been encrypted, was found on only on users’ desktops, but also on ATM screens, parking meters, digital billboards, and industrial control systems.

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Topics: Electronic Health Records

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