SOURCE: LogixHealth

LogixHealth

April 29, 2016 13:19 ET

LogixHealth Analyzes Recent Proposed Rulemaking for the Medicare Access and CHIP Reauthorization Act

BEDFORD, MA--(Marketwired - Apr 29, 2016) - LogixHealth, a leading provider of internet and software enabled coding, billing, analytics and management services for hospital and physician practices nationwide, provides services for millions of Emergency Department (ED) visits across 35 states, and has analyzed the implications of the CMS Proposed Rule related to the Merit-Based Incentive Payment System (MIPS), the Alternative Payment Model (APM) Incentive, and the Criteria for Physician-Focused Payment Models. 

In an effort to promote higher quality care the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) repealed the SGR formula and created a new payment framework by establishing two future payment incentives, MIPS and the Alternative Payment Models (APMs).

MIPs was created by combining three existing quality programs (PQRS, Value Based Payment Modifier and Meaningful Use) with a new program (Clinical Practice Improvement Activities). MIPS reimburses high value care by scoring four categories:

1. Quality (50% of score): Requires reporting six measures from a menu accounting for specialty differences.

2. Advancing Care Information (25% of score): Clinicians select customizable measures emphasizing technology interoperability and information exchange.

3. Clinical Practice Improvement Activities (15% of score): Over 90 options available including care coordination, beneficiary engagement, and patient safety.

4. Resource Use (10% of score): Claims-based measure utilizing 40 episode-specific measures that account for specialty differences.

"The consolidation of the disparate value-based programs into MIPS streamlines the complexities of satisfying the various requirements," states Michael Granovsky, MD President of LogixHealth.

Providers can exempt themselves from MIPS and qualify for financial bonuses by participating in an available Alternative Payment Model (APM), which include:

  • Comprehensive ESRD Care Model (Large Dialysis Organization arrangement)
  • Comprehensive Primary Care Plus (CPC+)
  • Medicare Shared Savings Program - Track 2
  • Medicare Shared Savings Program - Track 3
  • Next Generation ACO Model
  • Oncology Care Model Two-Sided Risk Arrangement (available in 2018)

The 962-page MACRA notice of proposed rulemaking is available on the LogixHealth website at: www.logixhealth.com

About LogixHealth:
LogixHealth, a leading provider of internet and software enabled coding, billing, analytics and management services for hospital and physician practices nationwide, provides services for millions of Emergency Department (ED) visits across over 35 states. We provide tools and resources to optimize financial performance and improve the quality of care. For more information, visit www.logixhealth.com.

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