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Monthly Archives: October 2016

How to Prepare Your Practice for MACRA/MIPS

MACRA & MIPSThe Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) has replaced the Sustainable Growth Rate (SGR) formula. As a result, new guidelines for paying providers for care administered to individuals enrolled in Medicare Part B will come into effect for the following calendar year.  

Providers that participate in MACRA through the Merit Based Incentive Payments System, or MIPS, reimbursement structure will be compensated based on the quality and efficacy of the care they provide. Through this system, providers will receive a composite performance score, which will be derived based on:

  • PQRS standards for care quality (will account for 50% of the total score)
  • VM standards for resource use (10% of total score)
  • Clinical practice improvement based on the new CPIA program (15% of total score)
  • Meaningful use of certified EHR technology (25% of total score)

Providers will then receive an adjustment to the base rate of their Medicare Part B reimbursements. These adjustments can be positive, negative, or neutral. With the reporting period for the new criteria beginning January 1, 2017, how can you prepare your practice for value-based care using the MACRA/MIPS reimbursement structure?

Understand How to Avoid Penalties & Choose How You Will Participate

Andy Slavitt, Acting Administrator of the Centers for Medicare and Medicaid Services has recently outlined three ways in which physicians can participate in the first MIPS reporting period of 2017 in order to avoid a negative adjustment for payment in 2019.

  1. Test the Quality Payment Program

This first option is intended to gauge whether the physician’s system is working and that their practice is prepared for broader participation in the Quality Payment Program in subsequent years. As long as providers send some data, including information from after January 1, 2017, to the Quality Payment Program, they will not be given a negative payment adjustment.

  1. Report to the Quality Payment Program for part of the year

Eligible providers can choose to submit information to the Quality Payment Program after January 1, 2017. As long as providers report information outlined for the composite performance score, their practices could qualify for a slight increase in their adjusted payment.

  1. Report to the Quality Payment Program for the full year

If practices are prepared to start reporting for the 2017 calendar year, they may start submitting information to the Quality Payment Program on January 1st. If practices submit information required by the criteria outlined for the composite performance score for the entire 2017 reporting period, they may qualify for a larger positive payment adjustment.

Fulfill Criteria of Existing Incentive Programs

The Merit-Based Incentive Payments System (MIPS) reimbursement structure is a combination of the following, existing incentive programs:

  • Physician Quality Reporting System (PQRS)
  • Value Modifier (VM or Value-Based Payment Modifier)
  • Medicare Electronic Health Record (EHR)

Currently cooperating with these programs will make the transition a lot smoother. Incorporating the use of certified EHR technology (CEHRT) with a meaningful use reporting module is an efficient way to meet requirements associated with both Meaningful Use and PQRS programs.

The finalized rules for participation and reimbursement will be published in November and the full MACRA timeline can be viewed here.

1st Providers Choice Can Ensure Your Practice Meets MACRA Requirements

1st Providers Choice EMR and practice management software can ensure you meet the necessary requirements outlined by MACRA for a positive reimbursement adjustment. For more information, contact us online or call us at 480-782-1116.

Is Interoperability With Pharmacy Automation the Next Step for EMRs?

Interoperability EMRsDue to an increasing amount of high-deductible health insurance plans, patients are becoming more engaged consumers. As a result, physicians and practices are looking for ways to increase the value of their care while keeping their practices running efficiently.

EMR software and pharmacy automation are two IT solutions that have made a large impact on healthcare systems. Therefore, it’s no wonder physicians are asking: how can interoperability between EMRs and pharmacy automation contribute to cost-efficient and value-based care? Read More

Need to Replace Your PTOS Billing and Practice Management Software

Move Your Practice From PTOS to 1st Providers Choice With Zero Downtime.

Switching from PTOS EMR to 1st Providers ChoiceIf your practice currently uses PTOS billing and practice management software and is looking to switch, 1st Providers Choice is prepared to help. Switching billing software programs can be a huge hassle to you, your staff, and your patients. Fortunately, the transition of moving is much easier with 1st Providers Choice. We offer live data conversions for all your PTOS patient data, insurance carriers, referring providers, and patient appointment data.

1st Providers Choice has over 31 years of experience in the physical therapy software industry. Our EHR and practice management software is fully ONC certified. 1st Providers Choice gives you the freedom to access your EMR software from anywhere. Our platforms are all accessible with mobile electronic devices such as iPhones, iPads, and Android devices. 1st Providers Choice also offers an easy-to-use therapy patient portal allowing patients to document their subjective complaint prior to their onsite visit. This allows therapist to save tons of clinical documentation time.

If you’re using a PTOS billing and practice management software, it’s time to change. 1st Providers Choice has consistently been a top choice for organizations switching to a new billing and practice management software program. We’re experts in PTOS data conversions so we can ensure your practice has zero downtime. Make sure your practice makes the right choice when switching therapy software programs.

If you’re interested in a free online therapy software demonstration or have any questions, please contact us online or by phone at (480) 782-1116.