Nov 7, 2017 7:30:00 AM

15 Takeaways You'll Want to Know From the QPP Year 2 Final Rule

The Centers for Medicare & Medicaid Services (CMS) issued on November 2nd its final rule with comment period for the MACRA Quality Payment Program (QPP) Year 2. With a continued focus on providing flexibility and reducing administrative burdens, CMS listened to stakeholders’ concerns and challenges by promising to:

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Topics: Quality Payment Program, MIPS and MACRA, QPP, CMS

Oct 26, 2017 11:00:00 AM

MedPAC on MIPS: What You Need to Know Now

MIPS is, and always was, a short-term strategy. The MACRA architects designed the Merit-based Incentive Payment System as a stepping stone to participation in Advanced Alternative Payment Models (AAPMs), which they envisioned as the better avenue to improve population health and bring down costs.

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Topics: MIPS and MACRA, MedPAC

Jan 5, 2017 10:30:00 AM

Medicare-Medicaid ACO Model: Urge Your State to Apply by Jan. 20

January 20 is a significant date for healthcare providers—but not necessarily for the reason you think.

Yes, there is the inauguration of the 45th President of the United States, who has vowed to “repeal and replace” the most significant healthcare legislation in recent history.

But that date has even greater significance for the many providers across the country who are struggling to cover the cost of care of an increasingly high-risk, low-income population.

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Topics: Healthcare Reform, APMs, MIPS and MACRA, MIPS CMS

Dec 6, 2016 10:00:00 AM

My Hospital is Losing Millions on Physician Practices—Part Two

We described in the previous installment in this series how recent case law and DOJ settlements provide clear evidence of the position of qui tam relators, prosecutors, and government experts that losses on hospital operation of physician practices are being targeted. Because evidence suggests that hospital losses on physician practices are common in many markets, the questions on everyone’s mind are whether health system losses on physician practices put the organization and key individuals at significant fraud and abuse compliance risk, to what degree can existing physician practice losses be justified through documentation, whether the health system has a functional Fair Market Value (FMV) and Commercial Reasonableness (CR) enterprise risk management process, and—the subject of this series--is a plan at the ready to begin mitigating practice losses?

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Topics: Hospital Valuation, Quality Payment Program, MIPS and MACRA, MIPS Healthcare

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