Now in its seventh year, the Merit-Based Incentive Payment System (MIPS) continues to create confusion, especially for specialists. The program can have a big impact on Medicare Part B reimbursements, using the MIPS composite performance score to determine if providers will receive a payment bonus, a payment penalty, or no payment adjustment at all. Adjustments are based on performance in four categories: quality, cost, promoting interoperability, and improvement activities. The biggest challenge for providers is to report data for at least six quality measures for a minimum number of cases for each calendar year. This poses an additional challenge for specialty providers as most of the measures were designed around the most common point-of-service where Medicare participants receive treatment – primary care.

As we kick off 2024, we wanted to start the new year with a series of 2024 Health IT predictions. We asked the Healthcare IT Today community to submit their predictions and we received a wide ranging set of responses that we grouped into a number of themes. In fact, we got so many that we had to narrow them down to just the best and most interesting. Check out our community’s predictions below and be sure to add your own thoughts and/or places you disagree with these predictions in the comments and on social media.

Building trust, examining data, and getting started: Leaders offer guidance on health equity

Chief Healthcare Executive | January 2, 2024

When listing their top objectives, hospital executives consistently cite improving health equity among their highest priorities. It’s been a popular discussion topic at healthcare conferences over the past year. Health equity is a glaring issue in cities and rural communities around the country. Leaders that are working in health equity speak with urgency about the need to close disparities, but they also acknowledge that such efforts will require long-term commitments.

According to critics, a decade of value-based care (VBC) efforts have proven an abject failure, improving neither cost nor quality of healthcare. Over 50 VBC program implementations have collectively lost billions of dollars as compared to traditional fee-for-service (FFS) benchmarks, they say, and can boast little to no clear improvement in quality outcomes. In short, “there just isn’t any real value to be had in value based care.” As a proponent of VBC, I’ve spent a lot of time learning from value based care experts on both the payer and provider side. And I can say that the critics are indeed right—from a certain perspective.

On occasion, we showcase one of our solution providers in a 4-5 minute interview and ask them what they bring to the VBC Community and what sets them apart. 

Today's guest:

Discover Lucerna Health - Your path to making value-based care (VBC) work for better health and better business results! Lucerna's innovative healthcare technology and deep industry expertise enable them to help you achieve your growth, health outcomes, and revenue goals with their proven playbook. Lucerna believes that payer-provider collaboration and consumer-focused healthcare are essential requirements for VBC success. Lucerna's HITRUST R2-certified LEAP VBC OS platform drives data management & analytics, digital enablement, patient-provider matching, and smart patient engagement. With a unique turn-key managed services approach, Lucerna delivers impactful results in Patient Growth, Navigation, Engagement, and Experience for their clients.

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