"As January nears, healthcare organizations should consider how they will comply with the Merit-Based Incentive Payment System (MIPS) for 2020. With the new year bringing increased performance thresholds and a renewed emphasis on interoperability and performance improvement, providers may be uncertain about how to approach compliance to ensure optimal outcomes.
Ophthalmologists are trained to provide the full spectrum of eyecare, from prescribing glasses to precision eye surgery. Yet while they may be experts at treating patients, very few have business degrees or specialized practice management skills. Poor real estate decisions and bad hires, for example, are common mistakes that constitute part of the typical learning curve. However, many doctors make serious financial mistakes that can devastate their businesses, such as choosing the wrong electronic health record (EHR) and then sticking with it because of sunk costs.
Now that the ICD-10 coding system has been up and running for just over a month, we are starting to see some reports back from the trenches. And those reports are surprisingly good. The sky did not fall in and the world did not come to an end. For most practices, denials did not go through the roof. Robert Tennant, senior policy advisor for the Medical Group Management Association, was at a Town Hall meeting a couple of weeks ago with Humana and Emdeon (a medical claims clearinghouse) and both organizations reported that they were seeing no great increase in denials and no big drop in the number of claims submitted.
Specialty providers who have pursued meaningful use incentives can confirm that the program certainly was not designed for them. That’s not to say that the incentives aren’t worth the effort, however. The Centers for Medicare and Medicaid Services has paid out more than $25.7 billion in incentive payments as of Dec. 1, 2014. Any provider who has implemented an EMR and realizes significant revenue from Medicare or Medicaid billings, but didn’t take the time to seriously look into meaningful use, may have left money on the table — and may be subject to penalties that begin in 2015.
Federal healthcare initiatives tied to reimbursement, which invariably apply to all healthcare providers, tend to mean equal pain for unequal gain to specialty practices.
David brings over a decade of executive management experience in healthcare information technology to his role as president and CEO of Nextech. In this special guest appearance on the Healthcare Insider radio show,c under the Centers for Medicare and Medicaid Services’ (CMS) EHR Incentive Program. Listen to this interview