Understanding and Complying With the CMS Quality Reporting and Incentive Programs
1 hour 5 minutes
Gain a better understanding of the CMS Quality Reporting Program, Value-Based Purchasing Program, and other initiative and incentive programs.
At Congress’s direction, the Centers for Medicare & Medicaid Services has transitioned physician payments from a strictly fee-for-service program to a complex payment system that hinges on physicians’ participation in value-based payment programs. Physicians, practice managers, and third-party vendors that offer health information technology solutions must meet various regulatory requirements to ensure successful participation in value-based payment. This material will help the persons responsible for quality reporting and implementing electronic health records understand the requirements of these regulations and avoid problems that could lead to lower reimbursement. This material will also explain the implications of practices shifting to Alternative Payment Models like Accountable Care Organizations and discuss methods for exchanging Protected Health Information between practices participating in these integrated care models in compliance with HIPAA.
• You will be able to describe the CMS Quality Payment Program and its requirements.
• You will be able to discuss the ongoing transition of Medicare from a pure fee-for-service model to a value-based care model.
• You will be able to identify potential pitfalls that health care providers often face when attempting to comply with CMS reporting requirements.
• You will be able to define clinical MIPS quality measures, electronic clinical quality measures, and improvement activities.