What’s next for EHR Incentive Programs and Medicare Reimbursement?

Heather Carley

Heather Carley, EHR Incentive Program Specialist

The landscape of health care has been changing for several years.  It’s been a virtual alphabet soup of incentive program acronyms (MU, PQRS and VM to name a few).    As a practice manager and an independent incentive program consultant, keeping up with the constant change of incentive program requirements has been challenging, to say the least.

Despite rumors, CMS incentive programs are not going away, but….there is good news!

The Medicare Access and CHIP Reauthorization Act (MACRA) of 2015, a bipartisan legislation, signed into law April 2015 restructure the above-mentioned incentive programs into a new framework called the “Quality Payment Program”.

What does this mean for those of us in the trenches?

It means there is finally one program!  The multiple programs we’ve been juggling have been streamlined into the Merit-based Incentive Payment System (MIPS).  The revised program is expected to reduce reporting burdens for clinicians, which is something I think we all welcome.

Just last week the Department of Health and Human Services issued a Notice of Proposed Rulemaking (NPRM), which provides the outline of the key provisions of the Quality Payment Program.

The Quality Payment Program is a fresh start!  It’s a way for Medicare Part B providers to focus on “better, smarter, healthier care”.  I know it will be welcomed by the many practices I have worked with who have thrown their hands up and taken the payment modifications (penalties), because it was simply too much.

While we still have to await the finale rule, due sometime the fall, it’s not too early to familiarize yourself with the proposed program details.  In fact, I strongly recommend and believe in preparing your practice to be an early adopter. Especially since the first year of the Quality Payment Program goes into effect in 2017 (the first performance period begins in January for the 2019 payment year).

Wait, there is more good news!  You don’t have to wait until the final rule to know “what’s what”.  Educational opportunities are already available.  I’ve already attended webinars offered through my EHR vender and CMS.  And I am proud to have partnered with EHR 2.0, HIPAA consultants and compliance experts, to offer an overview of the Notice of Proposed Rulemaking and the Quality Payment Program. If you missed the free 50 minute webinar on May 19th, simply click the link below to watch the free webinar recording.

View Recorded


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