Accelerated Medical Practice Blog

A healthcare technology blog, sponsored by White Plume Technologies.

22
Mar

Medicare Advantage & HCC Coding

Posted by on in Medical Coding

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Medicare Advantage plans were the first to use HCC for Risk Adjustment in 2004.  The way the Risk Adjusted program worked was relatively simple: the Medicare Advantage plan would assume both upside and downside risks for their patient population, and CMS would have a fixed price for these patients.  However, the critical element to making this work and avoiding “cherry picking” was HCC Risk Adjustment.  Without HCC Risk Adjustment, Medicare Advantage plans would receive a... Continue reading
16
Mar

Importance of Diagnosis & HCC Coding

Posted by on in ICD-10

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Diagnosis Coding is Becoming Increasingly Important Diagnosis coding is becoming more and more important.  During the “Good Old Days” (think pre-Meaningful Use) as well as during the Meaningful Use Era, diagnoses were primarily required to justify the medical necessity of CPT codes for reimbursement under Fee-for-Service.  As the healthcare reimbursement process shifts towards a Value-Based model, Fee-for-Service will continue. However, there are many other reporting mechanisms that will now utilize diagnosis codes. Most practices will... Continue reading
23
Feb

MIPS Advancing Care Information Measure

Posted by on in White Plume
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Advancing Care Information, or ACI, is a simplified version of the retired Meaningful Use program.  Many of the most disliked MU requirements (CPOE, Clinical Decision Support) are no longer required.  The required elements of ACI focus on: ePrescribing, patient access to their chart, HIPAA security risk assessment and HIE.  Partial credit scoring is now available rather than the all or nothing scoring under MU. ACI is 25% of the aggregate MIPS score. FIVE core ACI measures are... Continue reading
23
Feb

MIPS Improvement Activities Measure

Posted by on in White Plume
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Improvement Activities is a new category that was created to improve patient access and the patient experience.  Practices and eligible clinicians have a lot of flexibility to choose the Improvement Activities that are most beneficial to their patients and practice.  There are a total of 93 activities and 8 different domains from which to choose.  The score in this category will comprise 15% of the aggregate MIPS score. Only 1 Improvement Activity is required during the... Continue reading
23
Feb

MIPS Quality Measure

Posted by on in White Plume
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The Quality category is nearly identical to the PQRS program.  Eligible clinicians can choose the quality measures that are most meaningful for their specialty and their patients.  Providers can choose from a total of 271 measures across 6 domains.  For the 2017 transition year, quality will be 60% of the aggregate MIPS score, this will decrease to 30% by 2019. In order to avoid the negative adjustment in the Quality Measure during the 2017 MIPS transition,... Continue reading
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