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:

•Two-midnight rule

•Medical necessity of services

•Unbundling 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.


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