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of provider groups avoided VM penalties in 2016
in incentives paid to our providers since 2011
Meaningful Use Stage 2 attestation rate for 2015
Don’t Leave Money on the TableWith past programs like PQRS and Meaningful Use, and new programs like MIPS, there’s significant revenue on the line.
What’s at stake with value based reimbursement?Here’s a look at an actual athenahealth client with a breakdown of the money they stand to lose and, more important, the money they can gain for the quality care they already deliver. This practice has 13% of their annual revenue in the balance. How much money is at stake at your practice?
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Avoid the penaltiesThe Physician Quality Reporting System: This year, more providers than ever are facing penalties for failing to report CMS’ Physician Quality Reporting System (PQRS). And with 60% of providers nationwide paying penalties for failing to satisfy their PQRS measures, practices are feeling the pain. At athenahealth, our providers are in the clear, with 93.6% of our clients reporting PQRS compliance.
Meaningful Use Stage 2: Failing to attest for Meaningful Use now results in increasing penalties for providers across the nation. In 2014, roughly 33% of providers nationwide attested to Meaningful Use, leaving the rest to pay penalties. The landscape for athenahealth clients is quite different, with 98.2% of our participating providers successfully attesting to Meaningful Use Stage 2 in 2014.
Get paid more with new revenue opportunitiesIf you’re already managing chronic care or providing transitional care, you should be taking full advantage of higher reimbursements from Medicare through the Chronic Care Management (CCM) or the Transitional Care Management (TCM) programs. There are also substantial incentives in the Value-based Modifier (VM) program that are awarded to providers for high-quality, low-cost care. Our 5 MD practice above received an additional $355,702 through incentive payments in these programs.
*VM & HCC values based off of CMS’ 2015 x-factor: Page 3: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3170615/
**CCM values based on CMS data that two out of three Medicare beneficiaries have two or more chronic conditions: Page 2: https://www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNProducts/Downloads/ChronicCareManagement.pdf
†TCM data based on CMS national average that 14% of beneficiaries have an inpatient episode followed by a post-acute visit: Page 16: https://www.cms.gov/Research-Statistics-Data-and-Systems/Statistics-Trends-and-Reports/Chronic-Conditions/Downloads/2012Chartbook.pdf
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