Medicare Archives - MEREM Health https://www.meremhealth.com/tag/medicare/ Wed, 27 Mar 2019 18:35:56 +0000 en-US hourly 1 2019 MIPS & MACRA – Are Your Physicians Hitting the Medicare Mark? https://www.meremhealth.com/2019-mips-macra-are-your-physicians-hitting-the-medicare-mark/ Tue, 11 Dec 2018 23:11:57 +0000 https://www.meremhealth.com/?p=1461 MACRA (Medicare Access and CHIP Reauthorization Act of 2015) is U.S. healthcare legislation that provides a new framework for how Medicare pays for physician services by incentivizing those who successfully demonstrate value over volume in patient care. MACRA combines parts of the Physician Quality Reporting System (PQRS), Value-based Payment Modifier (VBM), and the Medicare Electronic Health Record...

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]]> MACRA (Medicare Access and CHIP Reauthorization Act of 2015) is U.S. healthcare legislation that provides a new framework for how Medicare pays for physician services by incentivizing those who successfully demonstrate value over volume in patient care.

MACRA combines parts of the Physician Quality Reporting System (PQRS), Value-based Payment Modifier (VBM), and the Medicare Electronic Health Record (EHR) incentive program into one single program called the Merit-based Incentive Payment System, also known as MIPS.

In November, the Centers for Medicare and Medicaid Services (CMS) released their FINAL RULE for the 2019 Medicare Physician Fee Schedule. This Final Rule will go into effect January 1, 2019 for many clinicians and it is the start to the new physician payment provisions also known as the QPP. The CMS Quality Payment Program (QPP) has two tracks: the Merit-based Incentive Payment System (MIPS) and Advanced Alternative Payment Models (APMs).

What is MIPS?

This is a healthcare law that doctors across the country, who accept Medicare patients, need to abide by in order to maintain or qualify for an increase in their reimbursement payments from the government. These physician incentives are based on clinical performance in four specific categories, Quality, Cost, Promoting Interoperability, and Improvement Activities.

The biggest changes in MIPS 2019

MIPS category change review according to “HIT Like a Girl” podcast.

These MIPS scoring weights have changed each year. The biggest changes in 2019 are

  • Quality score reduced from 50% to 45%
  • Cost score increased from 10% to 15%
  • Improvement Activities: Interoperability bonus removed
  • Eligible clinicians must use 2015 edition or newer certified EHR technology
  • Performance Threshold minimum increased from 15 to 30 points. Exceptional Performance Range is at least 75 points.

For 2019, the Weights and MIPS final scoring rules, we found this webinar from Healthmonix to be extremely helpful.

In summary:

  1. Quality (45%) – Requires 6 measures to be reported with 1 outcome measure or high priority (specialty measure set)
  2. Cost Performance Reporting (15%) – based on 8 measures, 10 minimum procedural episodes such as knee arthroplasty, or 20 acute inpatient medical condition episodes
  3. Promoting Interoperability (25%) – Must report at least a 90 day period, Must use 2015 ed. or newer CERTEHR technology
  4. Clinical Practice Improvement Activities (15%) – 40 points required, based on weight.

If you are preparing for MIPS 2019 reporting, we hope this blog prepares your practice performance measures.

At MEREM Healthcare Solutions, we want to be your strategic partner in making sure your practice needs are met and your practice improvement and profitability are the end result. Contact us today to learn how our knowledgeable and experienced professionals can help assist or consult you with EMR technology and MIPS and MACRA submissions for your physicians.

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]]> Is Your Practice Ready for the New Medicare Cards and MBI Roll Out? https://www.meremhealth.com/2018-2-26-is-your-practice-ready-for-the-new-medicare-cards-and-mbi-roll-out/ Mon, 26 Feb 2018 18:47:50 +0000 http://encorelumber.azurewebsites.net/2018/02/26/2018-2-26-is-your-practice-ready-for-the-new-medicare-cards-and-mbi-roll-out/ The Centers for Medicare and Medicaid Services (CMS) are rolling out a campaign issuing new health identification cards to all Medicaid and Medicare recipients beginning April 1, 2018. The issuing of new cards and MBIs (Medicare Beneficiary Identifiers) requires all practices to prepare and adjust their workflows and technology systems to ensure they are prepared for this major information change in order to avoid payment delays.

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]]> The Centers for Medicare and Medicaid Services (CMS) are rolling out a campaign issuing new health identification cards to all Medicaid and Medicare recipients beginning April 1, 2018. The issuing of new cards and MBIs (Medicare Beneficiary Identifiers) requires all practices to prepare and adjust their workflows and technology systems to ensure they are prepared for this major information change in order to avoid payment delays.

Our consulting team at Merem Healthcare Solutions is here to help you with training your front office staff to execute their more technical responsibilities such as processing new MBIs. We offer both on-site and remote training, so there is a solution to fit any size staff and any size budget. The Merem Healthcare Solutions consulting team comes in to help your staff (and your practice) reach their maximum potential at benefit verification and up-front collections.

Tips to Prepare Your Practice for New MBIs

1) Educate practice staff about the roll-out of new Medicare cards with new MBIs

The issuing of new health identification cards to all Medicaid and Medicare recipients begins April 1, 2018. These replacement cards will be distributed in phases over the next 12 months in an effort to prevent Medicare fraud and protect beneficiaries from identity theft.

Image Source: https://www.cms.gov/medicare/new-medicare-card/nmc-home.html , Obtained 2.20.18 Image Source: https://www.cms.gov/medicare/new-medicare-card/nmc-home.html, Obtained 2.20.18

2) Ensure your staff can identify the new Medicare Cards and MBI

  • The new Medicare cards will have an updated look. These cards will be issued to a beneficiary for life and will not include any distinguishing demographics such as gender, birthdays, or signatures.
  • Like the current HICNs, MBIs will be 11 characters long. However, MBIs will contain uppercase letters and numbers.
    • To avoid numbering confusion, MBIs will never contain the letters: B, I, L, O, S, and Z
    • Positions 2, 5, 8, and 9 will always be letters
  • Each beneficiary will be assigned their own individual MBI. Unlike HICNs, MBIs will not be associated with their spouse or dependents.

3) Begin discussing the new Medicare cards with your patients now.

This will ensure they are prepared for the arrival of their new cards and know to bring it in with them to their next appointment.

Suggestion: Share this short video in your lobby https://youtu.be/DusRmgzQnLY

 

4) Beginning in April 2018, prompt your practice staff to ask a patient for their new Medicare cards

Eligibility responses include a message indicating that CMS has mailed new cards.

Merem Healthcare Solutions is happy to now offer consulting services to our client partners. Whether you need to improve your front office processes, improve clinic output, or coaching on your encounter documentation, Merem has a consultant that can help.

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