Healthcare IT Interoperability, EHR interoperability, Hospital Interoperability

MACRA

AHIP Supports Demo of Medicare Advantage Plans as Advanced APMs

November 14, 2017 - AHIP has voiced its support for a CMS demonstration project that would allow Medicare Advantage (MA) plans to qualify as Advanced Alternative Payment Models (APMs), the organization wrote in a statement to CMS. The payer advocacy group believes that the Quality Payment Program (QPP) has the potential to continue high consumer satisfaction rates with MA plans and encourage payers and...


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AHIP Sees 28% Increase in Medigap Enrollment Among Seniors

by Jesse Migneault

AHIP has released data showing that enrollment in the Medicare Supplement, Medigap, has seen a steady increase from 2014 to December 2015.   The data represents statistics from 11.8 million enrollees with policies from 305...

CMS Extends Pediatric Alternative Payment Model Comment Period

by Thomas Beaton

CMS will continue to take public comment on its pediatric alternative payment model (APM) initiatives until April 7, 2017.   In March, CMS issued a request for information (RFI) related to establishing an APM specifically focused on...

Doctors Provide 5 Alternative Payment Model Improvements

by Thomas Beaton

A journal article published in the American Journal of Managed Care, outlines recommendations from several doctors on significant ways alternative payment models (APMs) can be improved and better designed. APMs are being promoted...

84% of Physicians Unsure of Quality Payment Program Conditions

by Vera Gruessner

As many as 84 percent of polled independent physicians and medical staff are unaware of how to meet the requirements of MACRA’s Quality Payment Program, according to a survey from Kareo. The majority of surveyed physicians,...

How MACRA Requirements Impact Accountable Care Organizations

by Vera Gruessner

MACRA legislation impacts a number of healthcare providers and entities including accountable care organizations (ACOs). Only a few Medicare accountable care organizations will actually be able to participate in Advanced Alternative...

MACRA Implementation Solutions Payers, Providers Should Follow

by Vera Gruessner

MACRA implementation will take place across the healthcare industry starting next year, as more and more providers begin participating in Advanced Alternative Payment Models (APMs) and and the Merit-Based Incentive Payment System (MIPS)....

Private Payers Falling Behind in MACRA Implementation, APMs

by Vera Gruessner

Earlier this month, the Department of Health & Human Services (HHS) announced the release of the finalized ruling for the MACRA legislation. Along with gutting the flawed Sustainable Growth Rate formula, MACRA legislation brings...

How Stakeholder Input on Quality Payment Program Differs

by Vera Gruessner

At the end of last week, the Department of Health & Human Services (HHS) released a final rule on the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) and its policies on the new Quality Payment Program. HHS reiterated in a...

HHS, CMS Announce Finalized Ruling for MACRA Legislation

by Vera Gruessner

The Department of Health & Human Services (HHS) announced in a press release the discharge of the final ruling on the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA). The MACRA legislation replaces the flawed Sustainable...

58% of Payers, Providers Adapt Value-Based Care Reimbursement

by Vera Gruessner

Several surveys from 2016 show that more healthcare providers and payers than ever before are implementing value-based care reimbursement contracts and moving away from traditional fee-for-service payment models. This past June, ORC...

How MACRA Resolves Sustainable Growth Rate Formula Challenges

by Vera Gruessner

The Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) will likely simplify and improve Medicare reimbursement processes due to the fact that it repeals the flawed sustainable growth rate (SGR) formula. The problems associated...

CMS Reveals 4 Options for Quality Payment Program Participation

by Vera Gruessner

The Centers for Medicare & Medicaid Services (CMS) is working toward assisting healthcare providers in meeting some new regulations that are part of the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA). The meaningful use...

CMS Bundled Payment Models Address Cardiac Care, Hip Surgeries

by Vera Gruessner

The Centers for Medicare & Medicaid Services (CMS) have recently begun implementing additional alternative payment models centered on episodes of care. CMS has proposed new rules for managing the costs of care and coordination among...

How the MACRA Rule, Baby Boomers Impact Medicare Payment

by Vera Gruessner

Last month, Andrew Slavitt, Acting Administrator of the Centers for Medicare & Medicaid Services (CMS), spoke at the American Medical Association 2016 Annual Meeting about new strategies to pay for Medicare and unlock opportunities for...

Coordination, Interoperability Key for MACRA Requirements

by Vera Gruessner

Last month, the Centers for Medicare & Medicaid Services (CMS) released proposed rules for the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA), which will essentially drop meaningful use requirements in favor of the...

MACRA Rule Revolutionizes the US Healthcare Payment System

by Vera Gruessner

Earlier this week, the Centers for Medicare & Medicaid Services (CMS) released a proposed rulemaking regarding the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA). The MACRA legislation has made a significant difference to...

New Proposed MACRA Rule Renovates Information Technology Use

by Vera Gruessner

The Department of Health & Human Services (HHS) has proposed new rules regarding the Medicare Access & CHIP Reauthorization Act of 2015 (MACRA) which will essentially remove the meaningful use program and move forward in advancing...

MACRA’s Merit-Based Incentive Payment System Removes SGR Flaws

by Vera Gruessner

Did you know that healthcare payment legislation passed earlier this year allows providers to take part in the Merit-Based Incentive Payment System (MIPS), a quality program from the Centers for Medicare & Medicaid Services? This past...

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