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[Infographic] Meaningful Use Incentive and Penalty Scenarios: Medicaid
The Meaningful Use incentive payment and penalty rules for the Medicaid program are different from the Medicare program. The infographic below illustrates the various scenarios for providers attesting...
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Meaningful Use Incentive and Penalty Scenarios: Medicaid
In a previous post, we discussed the recently publicized dropout rates for meaningful use (MU) attestations and the various incentive and penalty scenarios for providers dropping out of the Medicare...
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HHS Promises Big Changes – And Raises More Questions
This post was written by Jim Donohue, Senior Manager, and Richard Trembowicz, Senior Manager. Recently the U.S. Department of Health & Human Services (HHS) outlined ambitious goals to significantly...
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Planning for MACRA Begins Now
In April 2015, the Medicare Access and CHIP Reauthorization Act (MACRA) was signed into law, representing the most sweeping set of changes to Medicare’s physician payment methodology in more than two...
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Mandatory Bundled Payment: Getting into Formation for Value-Based Care
When the Centers for Medicare & Medicaid Services (CMS) launches the Comprehensive Care for Joint Replacement (CCJR) Model on January 1, 2016, it will signify one of the most dramatic steps toward...
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Bipartisan Budget Act Means Big Changes for New Off-Campus HOPDs
The highly publicized Bipartisan Budget Act of 2015, approved by the Senate on the morning of October 30, will do more than just raise the nation’s debt ceiling. It also will exclude newly acquired,...
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The Divergent Paths of MACRA
“Two roads diverged in a yellow wood/And sorry I could not travel both.” No federal legislation will ever be mistaken for poetry. For one thing, poetry uses far fewer acronyms. But like the narrator in...
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CMS Announces Final Rule for Joint Replacement Bundle Program
In a widely anticipated statement, the Centers for Medicare & Medicaid Services (CMS) announced on November 16, 2015, the publication of a final rule that will require certain hospitals to...
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The Not-So-Obvious Implications of MACRA
With the passage of the Medicare Access and CHIP Reauthorization Act (MACRA) this past April, a couple of things became evident. First, there are some concepts Congress can agree on – like the...
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MACRA Draft Plan Is Short on Details
On December 18, 2015, CMS released its draft plan for developing the quality measures that will be used within both the MIPS and APM components of MACRA. The purpose of this draft plan and the mandate...
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Newly Proposed Bill to Delay CJR Is Predictable and Pedestrian
While some of us were disappointed to see the sleepy bill that proposes to further delay the Comprehensive Care for Joint Replacement (CJR) bundled payment initiative, let’s be real: given how long it...
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MACRA Proposed Rules Provide Some Clarity, But Questions Remain
Last week CMS released its much-anticipated proposed rules for the Medicare Access and CHIP Reauthorization Act (MACRA), which was passed by Congress approximately 1 year ago and introduced substantive...
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CMMI Remains Bullish on Bundled Payments
On April 18, as anticipated, the Center for Medicare & Medicaid Innovation (CMMI) announced it would be extending one of the few healthcare programs that has actually saved the government money....
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MACRA Forces Providers Seeking APM Track to Move Quickly
In the recent proposed rules for MACRA, CMS offered some clarity for providers who are trying to decide whether to participate under the Merit-Based Incentive Payment System (MIPS) or the Alternative...
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A Banner Year for Bundles
An atmosphere of urgency permeated the National Bundled Payment Summit in Washington, D.C., earlier this month. That shouldn’t be surprising, given the number of major announcements in the first half...
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Oncology Care Model Practices Announced
This post was written by Jessica Turgon, Principal, Matt Sturm, Senior Manager, and Meagan O’Neill, Senior Consultant. Earlier this week the Centers for Medicare & Medicaid Services (CMS) announced...
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CMS’s Proposed OPPS Rules Generate Confusion and Anxiety
CMS’s new proposed rules related to the Bipartisan Budget Act of 2015 would severely inhibit hospitals’ ability to expand and modify outpatient service offerings around the country. Issued on July 6,...
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CMS’s Mandatory AMI Bundle Is Cause for Chest Pain
This week the Centers for Medicare & Medicaid Services (CMS) announced a new mandatory bundled payment program for cardiac care. The proposed 5-year demonstration would go into effect on July 1,...
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