On June 6, 2016, the Centers for Medicare & Medicaid Services (CMS) issued its final rule (accessible at, https://s3.amazonaws.com/public-inspection.federalregister.gov/2016-13651.pdf) strengthening incentives for Accountable Care Organizations (ACO) in the Medicare Shared Savings Program (MSSP). According to the CMS Acting Administrator, the changes “will encourage more physicians to improve patient care by...
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Clinical Practice Improvement Activities: Become a Top Performer in this MIPS Category
The Medicare Access and CHIP Reauthorization Act (MACRA) streamlines existing quality programs into one Quality Payment Program. Each year participants will choose from 90 clinical practice improvement activities and 300+ quality measures. They will also submit data that will feed 40+ resource use measures and advancing care information measures. Here...
Stop Notification Fatigue! Untether from the EHR Inbox
A study was recently highlighted in JAMA Internal Medicine on the burden of Electronic health record (EHR) inbox notifications. On average, primary care physicians received 77 notifications per work day and specialists received 29 notifications. The study observed 46 primary care physicians and 46 specialists using both Epic and Centricity...
Why Healthcare Organizations Should Conduct a Mock IRO
Independent Review Organization (IRO): Why Your Healthcare Organization Should Conduct a Mock IRO Assessment. While inherent to most Corporate Integrity Agreements (CIA), mock IRO assessments are becoming increasingly popular and proving advantageous to healthcare facilities not under a CIA. Conducting a mock IRO using the Office of Inspector General (OIG)-approved...
Query Integration (DocEdge QI™) with DocEdge™ Communicator
Communication between Physicians and Case Management, Coding, Quality and Clinical Documentation Improvement (“CDI”) staff is often fractured, with physicians receiving queries through multiple channels (email, paper, fax, phone) and in varied formats. Inconsistent query quality, complicated query processes, and limited EMR integration negatively impact physician response times. Physicians are frequently...
HHS’s Cyber Security Efforts Examined by Subcommittee on Health
Recently, a number of hospital computer systems have been hacked and the hackers demanded ransomware. Wichita-based Kansas Heart Hospital is one of the hospitals that decided to pay the “small” ransom after the hackers locked files, a decision that the FBI does not recommend. This latest cyber-attack occurred just one week prior to...
Medicare and Medicaid Program Integrity
On May 24th, the Subcommittee on Oversight and Investigation held a hearing entitled “Medicare and Medicaid Program Integrity: Combatting Improper Payments and Ineligible Providers.” The hearing was held based on recent reports from the Government Accountability Office (“GAO”) and the Department of Health and Human Services (“HHS”) Office of the...
Staying Up-To-Date on MACRA
This past week, the Acting Administrator of the Centers for Medicare & Medicaid Services (CMS) took to social media to provide 4 Key Takeaways on the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) and the comment period: Reminder that providers have the opportunity to invite representatives from CMS...