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There is a tug of war underway in healthcare, and physicians are sitting squarely in the middle. On one side, patients are demanding providers’ attention and expertise to address often complex medical conditions. On the other, there are evolving regulatory requirements, such as those found in the 2019 Quality Payment Program (QPP), which requires providers to regularly submit detailed measures of quality, cost, interoperability and more. As a result of the constant push and pull, physicians are becoming increasingly frustrated and disheartened. Most entered the profession to treat and care for patients, however, they are becoming sidetracked as they try to effectively demonstrate their performance to receive adequate reimbursement.

Remember learning how to ride a bike? Although it was slightly nerve-wracking when your parents took the training wheels off, it was also empowering. You had moved beyond just getting the hang of things and were really making progress. You could travel past the end of the block and explore new possibilities. In some ways, this is similar to what healthcare organizations are going through with the 2019 Outpatient Prospective Payment System (OPPS) Rules.

With Valentine’s Day approaching, people are starting to celebrate love and friendship. However, given the competing priorities your front office staff deals with each day, they may have trouble putting their hearts into any festivities.

The coming festivities will bring a thrill of excitement for many people as they prepare to ring in 2019. For healthcare providers, this time of year can also present some unusual patient care situations, which could lead to a little atypical ICD-10 coding. Here is a brief look at several codes that might be getting increased attention in the next few weeks.

CMS released the Quality Payment Program Year 3 Final Rule on November 1st. The rule included the removal of 26 Quality Measures, the addition of 10 new Quality measures, and significant changes to the Promoting Interoperability category of the program. Nextech will be releasing more information on these changes in the near future, including a video outlining the changes with tips to prepare for the coming year. Until then, here are a few steps to get you started.

When it comes to MACRA’s Merit-Based Incentive Payment System (MIPS), change seems to be the only constant. The requirements associated with the MIPS program have been in flux since MACRA launched in 2015. Despite the moving parts, specialty providers must remain focused on program compliance to receive incentive payments and avoid penalties. Unfortunately, with all the unknowns, it is often hard to feel confident that a practice is set up for success.

As specialty practices begin to embrace value-based care models, many providers are considering technology that allows them to better capture information about the patient encounter, streamline financial operations and meet reporting requirements. Although this is a smart strategy, practices must be careful to not just bolt on solutions that operate in silos. Instead, they should look for technology that seamlessly integrates with other solutions, facilitating information exchange, enabling smoother processes and limiting the likelihood that key information will slip through the cracks.