January 4th, 2016
By: Heather DeCarlo
Electronic Health Records: Eligible Providers (EP) have wrapped up 2015 and now the question is “What’s next?”
On November 24, 2015, CMS published the 2016 Medicare Physician Fee Schedule (PFS). The 2016 PFS is the first proposed rule change since the Sustainable Growth Rate (SGR) formula by the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA). For EP’s, the PFS is important because it dictates the calculation of payment rates, including procedures added to telehealth, and adds a number of new policies that are a result of recently enacted legislation. Click here to read the Proposed policy, payment, and quality provisions changes to the PFS for Calendar Year 2016.
For EP’s who have struggled to understand and comply with multiple CMS reporting programs, the struggle is only becoming more difficult. In 2016, regulation updates will include documenting changes to the Physician Quality Reporting System (PQRS), Electronic Health Record Incentive Program, Comprehensive Primary Care Initiative, Value-Based Payment Modifier (VM), Medicare Shared Savings Program (Shared Savings Program), and Physician Compare. And as the reporting programs move toward a full alignment, EP’s could face penalties beyond 9%.
The good news out of all this change is that CMS will be moving this myriad of reporting programs toward the Merit-based Incentive Payment System (MIPS) and the Alternative Payment Models (APMs). MIPS will create structure with a new ‘all-in-one’ system and ease the confusion associated with making gains from incentive programs while avoiding costly penalties by allowing EPs to report for multiple reporting programs under one single program. To read more about MIPS, click here or for a brief MIPS summary, here.
EP’s that have previously participated under the Meaningful Use (MU) program now know they can meet multiple reporting programs (such as PQRS) by reporting Clinical Quality Measures using Certified Electronic Health Records Technology (CEHRT), specifically RxNT|EHR. In order to satisfy two mandatory Public Health Measures, EP’s will need to (1) use a CEHRT solution for the entire year in 2016 and (2) establish ongoing reporting with their state Public Health Agencies (PHA). RxNT|EHR has partnered with HealthCareXchange, LLC to help EP’s successfully complete these objectives. To find out how you can incorporate Public Registry Reporting, contact firstname.lastname@example.org or call 800-943-7968 option 3 to speak directly with an RxNT Team Member.