The AMA, along with national physician specialty societies, recently sent a letter to the Centers for Medicare & Medicaid Services (CMS) asking that the 2018 Merit-based Incentive Payment System (MIPS) reporting period be reduced from a full calendar year to a minimum of 90 consecutive days. That should happen because of a lack of timely and direct notification about whether a physician is considered MIPS-eligible.
It seems like the end of the 2015 PQRS reporting period wasn’t that long ago, with registries concluding their submission process on March 31st. But we are now more than halfway through 2016 with the end of the service year in sight. CMS will begin accepting PQRS submissions after December 31st. With a PQRS registry’s help, practices can start the reporting process and finish their submission any time before the March 31st, 2017 deadline.
If all of the talk about PQRS, MIPS, APMsQRURsand MACRA have you feeling dazed and confused, you are not alone! The healthcare market is abuzz with lots of initials and abbreviations lately and understanding all of these is key to comprehending the physician payment models of the future.
Fifty years ago, Avedis Donabedian, MD, MPH, of the University of Michigan, published his seminal paper, “Evaluating the Quality of Medical Care,” and created a framework that is still used tomeasurehealthcarequality. Donabedian divided quality measures into three categories: structure, processes and outcomes.
Medical Mutual of Ohio said Tuesday it will acquire the 105,000 members in the group and individual health insurance units of HealthSpan Partners.The deal will further consolidate the health insurance industry in Northeast Ohio, where Medical Mutual is already the biggest player. Financial terms of the deal were not disclosed.
What happened in 2015?Things spiked, like the price for a Daraprim pill, which grew 5,000 percent overnight.Things stopped, like low-volume surgeries at three prestigious academic medical centers.Some things exceeded estimates, such as the price of EHR rollouts, while others fell short, such as the acuity of the physician shortage.
Two new polls show mixed results since the Oct. 1 ICD-10 compliance date went into effect. While a survey by consulting firm KPMG found 79 percent of responding healthcare organizations believe thecode transition has been successful to date, a separate survey of doctors by physician social media network SERMO indicates the new billing codes are taking time away from patient care.
ICD-10 will provide an enhanced platform for physician practice. As of October 1, 2015, the ICD-10 coding classification will become the new baseline for clinical data, clinical documentation, claims processing, and public health reporting. Understanding patient encounters and preparing for the transition will be critical to the financial sustainability of each practice.
Aetna will pay $37 billion cash and stock to acquire Humana, the companies announced on July 3, in what will be the biggest health insurance merger to ever hit the industry.“The acquisitionof Humana aligns two great companies,” saidAetnachairman and CEO Mark Bertolini.
WASHINGTON —They are only four words in a 900-page law: “established by the state.”But it is in the ambiguity of those four words in the Affordable Care Act that opponents found a path to challengethe law, all the way to theSupreme Court.