Lantana Group Blog

Courtney Panaia-Rodi,
PMP, Director of PMO and
Meenaxi Gosai, Information Analyst

Posts Tagged ‘CMS’

Has the Clock Run Out on Electronic Claims Attachments?

With the shift towards value-based care, payers still need access to clinical information for reimbursement decisions as well as for cost and quality metrics and standardizing enough of the clinical record to satisfy the anticipated attachments reg would be an excellent next step in that direction.

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What Eligible Clinicians Need to Know About Proposed Changes to the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA)

The Medicare Access and CHIP Reauthorization Act of 2015 changed the way Medicare rewards clinicians for providing quality care. CMS released a proposed rule in April 2016 to carry out key provisions of MACRA and implement two payment paths available to “eligible clinicians” (EC) as part of the proposed “Quality Payment Program”: (1) the Merit-Based Incentive Payment System and (2) the Alternative Payment Model Incentive. The proposed “Quality Payment Program” replaces the Sustainable Growth Rate (SGR) formula for paying eligible clinicians based on value and quality of care, which aligns with CMS’s goal to replace Fee-for-Service (FFS) volume-based payment with a value-based system.

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Does Risk-Adjustment for Sociodemographic Status (SDS) Have an Impact on Hospital Performance?

Ongoing research examines the impact of applying sociodemographic status (SDS) risk-adjustment to the Centers for Medicare & Medicaid Services (CMS) quality reporting programs. The main driver for investigation is a community assertion that SDS risk-adjustment is necessary to accurately gauge the quality of care given to patients of diverse backgrounds. Contrary to popular belief, recent research produced evidence that SDS risk-adjustment has little to no impact on hospital performance ratings.

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MIPS

Earlier this quarter, CMS came out with a rule that establishes a new methodology for MIPS eligible providers and encourages eligible professionals to participate in APMs. Lantana supports several stages in the value-based purchasing information lifecycle, and we have a sharp interest in the success of these programs as a transformative agent for healthcare. Our…

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Proposed Delays to 2014 Meaningful Use Timeline & and Changes to Certified Electronic Health Care Technology (CEHRT). How will you be affected?

Today, CMS announced proposed changes to Medicare and Medicaid electronic health record incentive program timeline for 2014 and revisions to the CEHRT definition. As a courtesy, Lantana put this summary together outlining the changes and how they may affect vendors and care providers. The full fact sheet can be found here. Why the change? CMS…

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Setting the Standard: EHR Quality Reporting Rises in Prominence Due to Meaningful Use

In this article, published in the January 2014 Journal of AHIMA, thought leaders from Lantana Consulting Group and HHS’s Centers for Medicaid & Medicare (CMS) discuss the industry mandate to measure the quality of care provided to patients. The ability to measure healthcare relies upon standard data and data formats for electronic health records (EHRs) under the…

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Accelerating Health Information Exchange: Highlight from ONC/CMS Webinar

I recently dialed in for a webinar on Accelerating Health Information Exchange hosted by both the Office of the National Coordinator for HHS (ONC) and the Centers for Medicare and Medicaid (CMS). The government had received over 200 public comment submissions on policies that can strengthen the business case for exchanging information across providers seamlessly and securely. Here are some takeaways from the webinar.

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Mt. Washington Revisited

This paper examines changes in the health care industry since a contrarian proposal was submitted to CMS in January 2005.  That proposal focused on CMS exercising its commercial power as the market master in the purchase of healthcare in the U.S. to catalyze the emergence of a commercial heath record banking industry as an alternative…

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