Tag Archives: Centers for Medicare and Medicaid Services

Participating in the Medicare Shared Savings Program: When and Why

Once a year, the Centers for Medicare & Medicaid Services (CMS) accepts applications for participation in the Medicare Shared Savings Program (MSSP).  On March 22, CMS announced the deadlines for the 2018 application cycle. An organization interested in participating in the MSSP as an accountable care organization (ACO) effective January 1, 2018, must file a … Continue Reading

Clock Ticking on New Revenue Opportunity for MSSP ACOs

On December 8, the Center for Medicare and Medicaid Innovation (CMMI) announced two new models to increase patient engagement in care decisions by putting more information in the hands of Medicare beneficiaries. Under one of these models, the Shared Decision Making (SDM) Model, CMMI will pay ACOs participating in the Medicare Shared Savings Program or the … Continue Reading

Optimizing Your MIPS Score: Quality Measure Benchmarks and Reporting Mechanisms

The Medicare Quality Payment Program has officially launched, meaning most physicians (and most non-physician practitioners) now are in the initial performance period under the Merit-Based Incentive Payment System (MIPS).  With 60% of the MIPS composite score based on quality measures, the selection of the most appropriate measures, and the manner in which to report, is … Continue Reading

MACRA Delay? Don’t Count On It

You may have seen a headline or two last week stating that the Centers for Medicare & Medicaid Services (CMS) may delay MACRA’s effective date.  However, the agency has not announced any such delay.  Instead, CMS’ top official indicated the agency is considering some adjustments to the initial performance period. The U.S. Senate Finance Committee … Continue Reading

MIPS Proposed Rule: Big Changes to Medicare Physician Payments Starting in 2017

Good news:  2016 is the last year physicians have to report performance measure scores to the Centers for Medicare & Medicaid Services (CMS) to avoid up to a 9% reduction in Medicare Physician Fee Schedule (MPFS) payments under the Physician Quality Reporting System (PQRS), the Value-Based Modifier Program, and the Meaningful Use Program. Not-so-good-news:  A … Continue Reading

Mandatory Medicare Bundled Payments: Comprehensive Care for Joint Replacement

The Centers for Medicare & Medicaid Services (CMS) proposes to convert one of the voluntary programs--Bundled Payment for Care Improvement (BPCI)--into a regulatory mandate. Despite the limited evaluative data now available, CMS believes bundled payments hold great promise to improve quality and coordination of care through an entire episode of care.… Continue Reading

Chronic Care Management: Inquiring Minds Want To Know

On February 18, the Centers for Medicare & Medicaid Services (CMS) sponsored a National Provider Call (NPC) on Medicare reimbursement for chronic care management (CCM). The NPC was the first formal presentation CMS has made regarding CCM since it began paying for this service January 1, 2015. In conjunction with the NPC, CMS also released a Medicare Learning Network Fact Sheet on CCM.… Continue Reading

A Step in the Right Direction for Cardiologists: CMS Technical Correction to Physician Fee Schedule

Friday brought about a bit of good news for cardiologists. The Centers for Medicare and Medicaid Services (CMS) released a technical correction to the Physician Fee Schedule resulting in significant increases in fees for cardiac CT, cardiac catheterization and myocardial perfusion imaging procedures. Jack Lewin provides this summary of the corrections. This change does not … Continue Reading