Providers and Quality Reporting
The Affordable Care ACT (ACA) brought about aggressive changes in the healthcare delivery system.
•ACA is driving to implement healthcare reform with a focus on quality outcomes, affordability and access to care.
Key components include:
•Transition to value-based payment
•Advance care delivery through innovation
•Improve information dissemination including transparency on cost and quality for consumer decision making
•More regulatory oversight - OIG’s work-plan:
•Medical necessity of services
•Coding pair edits
•Improper use of modifiers
Providers are burdened with adopting these new programs and still maintain their robust practice. The MIPS & APMs are in place and 9% of reimbursements for services rendered are a risk. This can be quite overwhelming for anyone participating in the current Medicare environment.
What are the next steps for a busy physician practice? HQM consulting can provide viable solutions for a busy physician practice to achieve the desirable quality outcomes and the necessary reimbursements that will sustain their practice.