k-charlandValue-based purchasing and quality are hot topics in the healthcare industry of late, and there have been some significant developments occurring very recently. First there was the passage of the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA), which permanently repealed the sustainable growth rate (SGR) formula for physician reimbursement in the Medicare program. Second, the Centers for Medicare & Medicaid Services (CMS) issued the proposed rule to update Medicare payment policies and rates for the Inpatient Prospective Payment System (IPPS) and the Long-Term Care Hospital (LTCH) Prospective Payment System. The proposed rule will impact discharges occurring on or after Oct. 1, 2015.

For MACRA, two provisions of the legislation that have attracted attention include the Merit-Based Incentive Payment System (MIPS) and support for transition to alternative payment methods (APMs). Beginning in 2019, bonuses will be available for eligible professionals who score well in MIPS, which will become the new pay-for-performance program under the Medicare system. The current penalty calculations under the Physician Quality Reporting System (PQRS), electronic health records/meaningful use (EHRs/MU) and the value-based payment modifier (VBM) would end at the close of 2018.

In CMS's proposed IPPS Rule, proposed changes to VBP initiatives include:

  • Electronic Health Record Incentive Programs and Quality Reporting
  • Hospital Inpatient Quality Reporting (IQR) Program
  • Hospital Value-Based Purchasing (VBP) Program
  • Hospital Acquired Conditions (HAC) Reduction Program
  • Hospital Readmissions Reduction Program
  • Long Term Care Hospital Quality Reporting Program (LTCH QRP)
  • PPS-Exempt Cancer Hospital Quality Reporting (PCHQR) Program

CMS also just released the Medicaid and Children’s Health Insurance Program (CHIP) Programs; Medicaid Managed Care, CHIP Delivered in Managed Care, Medicaid and CHIP Comprehensive Quality Strategies, and Revision Related to Third Party Liability Proposed Rule and we are waiting on the ACO Proposed Rule – both having substantial content related to value-based purchasing and quality.

With so many Value-Based Initiatives aggressively underway Panacea is happy to announce that we have launched our newest website – VBPmonitor.com, joining the popular sites RACmonitor.com and ICD10monitor.com. Our goal is to bring you the latest news and information related to VBP and quality initiatives, including such topics as MACRA, the IPPS Rule, CMS's 2015 Impact Quality Measures Report, physician value-based modifiers, ACOs, and more. Our editorial board members include providers, physicians, academics, consultants, vendors, attorneys, former CMOs, former hospital CFOs, former CMS staff, and payors.

By registering at the VBPmonitor.com website, healthcare professionals can receive:

  • Our bi-weekly e-newsletter and special bulletins
  • The free white paper "What Value Are We Gaining from Value-Based Purchasing"
  • Additional free white papers in the series
  • Online broadcasts (to start before the end of 2015)
  • Educational webcasts  (to start July 2015)

If you haven't already registered to receive this free resource, register today at VBPmonitor.com receive our free whitepaper, "What Value are we Gaining from Value-Based Purchasing?" We look forward to becoming your # 1 trusted VBP and quality news and information source.