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Wound Care Articles and Insights
April 20, 2017

REALITIES OF THE CMS QUALITY PAYMENT PROGRAM

Melissa Bailey

The knowledge deficit associated with the two CMS Quality Payment Program (QPP) tracks, the Merit-based Incentive Payment System and the Advanced Alternative Payment Models, appears insurmountable among solo and small practices. Practitioners, who care for patients within hospital-based wound centers, are focused on meeting the needs of their patients through the rendering of quality care and lifestyle improvement measures.  Wading through the minutia required to learn the categories, data collection and submission methods of the Quality Payment Program, typically defaults to an extraneous abyss.    

The precursors to MIPS, which included Meaningful Use, Physician Quality Reporting System and Value-based Modifier, were viewed by many practitioners with blatant disregard. Moving forward, these prior programs appear to have been merely a glancing blow from CMS.  With bipartisan approval, the new Quality Payment Program, effective January 1, 2017, demands closer attention due to the far-reaching impact on both reimbursement and public reporting. 

Wound Care Advantage recognizes the challenges practitioners face in meeting the demands of the Quality Payment Program (QPP). This is precisely the reason WCA orchestrated a presentation by CMS at the Wound Care Advantage National Conference held in February 2017.

WCA was honored to have CMS representative, Jon Langmead, present to the attendees of the February conference.  Jon Langmead is a Health Insurance Specialist with the San Francisco Regional Office of the Centers for Medicare and Medicaid Services (CMS). Jon has been with CMS for 15 years and has worked in the Philadelphia and Boston Regional Offices, as well. Jon has been involved in outreach on a number of CMS programs, including Medicare Part D, the Electronic Health Records and E-Prescribing Incentive Programs, and the Affordable Care Act and enrollment into the Health Insurance Marketplace.

Jon exhibited the knowledge and experience critical to understanding the details of the Quality Payment Program.  He provided support and insight on the current and future direction of the program, impacting both clinical and administrative staff of all U.S. wound centers. Jon’s objectivity and recognition of the challenges facing the healthcare industry were very much appreciated.

Due to the complexity of the CMS Quality Payment Program, future Physician Alliance blog posts will focus on the individual categories independent of the other. In an attempt to dismantle the labyrinth of rules and regulations of MIPS into digestible segments, the next blog post will specifically dive into the Advancing Care Information (ACI) category. Previously Meaningful Use, the ACI construct resembles several of the prior Electronic Health Record required measures.

In an effort to meet the needs of our client base, we welcome questions and recommendations for future Physician Alliance blog posts.

 

Terrie Dittmeyer, RN, BSN, MBA                                                

Certified MACRA/MIPS Healthcare Professional (CMHP)

 

 

 

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