decisionhealth Newsletters, Part B News - 2016 Issue 3 (March)
Value-based modifier cuts, bumps hit practices; focus on 2016 reporting
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Article Overview
This article covers Medicare’s value-based modifier program, its connection to PQRS reporting, and how 2016 payment adjustments are affecting physician practices. It also discusses upcoming reporting changes, the shift toward MIPS, and practical considerations for reviewing quality and resource use reports and specialty measure sets. The piece is intended for coding, billing, and practice management professionals tracking physician quality reporting and Medicare reimbursement updates.
Why This Topic Matters
The article helps practices understand where Medicare payment adjustments are coming from, how reporting periods influence those adjustments, and what broader quality-reporting changes may matter for future reimbursement planning.
Article Sections
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Quality reporting
Introduces the Medicare quality reporting context behind the article and summarizes the overall effect on physician practices. It frames the discussion around current payment adjustments and related program results.
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What’s on the horizon
Discusses upcoming reporting deadlines, future program changes, and the broader transition in Medicare quality-based payment programs. It also notes how reporting scope and timing may affect later payment years.
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3 tips to get ahead of the VBM
Outlines general best practices for approaching the current reporting period, including selecting measures, reviewing available reports, and considering specialty-focused options. It also references the program’s relationship to future payment models.
What You Will Learn
- How the Medicare value-based modifier program relates to physician quality reporting
- What recent payment adjustment results mean for participating practices
- How reporting-period changes affect the timing of Medicare payment updates
- What broad steps practices can consider when preparing for future quality reporting
- How quality and resource use reports fit into Medicare performance monitoring
Who Should Read This
- Physician practices
- Medical coders
- Billing professionals
- Practice managers
- Reimbursement specialists
- Healthcare consultants
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