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Reimbursement Feature

MIPS Payment Program / Courtesy of CMS

CMS Approves Ortho Association for MIPS Clinical Data Registry

Walter Eisner • Wed, January 3rd, 2018

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Centers for Medicare and Medicaid Services (CMS) has approved the American Association of Orthopaedic Executives (AAOE) as a Qualified Clinical Data Registry (QCDR).

This is a big deal because the registry allows providers to collect the data needed to participate in the Merit-Based Incentive Payment System (MIPS) coming in 2019, and qualify for higher payments.

MIPS came out the ashes of the much-despised Sustainable Growth Rate (SGR) formula used to determine reimbursement rates for medical providers. The new reimbursement system consolidated numerous quality measurement programs so providers could be measured on quality outcomes.

Transition to MIPS

As CMS began to phase out of the Fee-for-Service (FFS) program it continued to apply a Value-Based Payment Modifier (Value Modifier) for differential payments to physicians based on the quality and cost of care they furnish to beneficiaries enrolled in the traditional Medicare Fee-for-Service program.

Under the Value Modifier, performance on quality and cost measures translated into increased payment for physicians who provide "high quality, efficient" care and decreased payment for "low-performing" physicians who underperform. The Value Modifier will expire at the end of 2018, as MIPS begins in 2019.

To prepare for 2019, the Association is touting a "truly affordable" rate to help providers measure such things as:

  • Patient Satisfaction
  • Patient Reported Outcomes
  • Quality Measures

The cost is only $100 per provider for 2018 and $200 for the following three years if you sign up by April 17, 2018. This rate includes access to one or all elements of the data warehouse, depending on your level of participation.

For more information on the AAOE QCDR, Data Warehouse, and Benchmarking Survey, visit www.aaoe.net/datawarehouse or contact AAOE Director, Data Solutions Vicki Sprague, Ph.D., at vsprague@aaoe.net or 317-749-0626.

AAOE President Ron Chorzewski, PT, MBA, Executive Director, Agility Orthopedics, said 19 practices and 243 providers are already participating. He added the registry “is an important addition to the resources AAOE members can use to better manage our practices and set the standard for excellence in the industry.”

In a December 27, 2017 press release, the Association said this is an important initiative of AAOE to "give back to the orthopaedic community" by providing all members, no matter their practice size, with a one-stop-shop for their data collection, benchmarking, and reporting needs.

The association was founded in 1969 as practice management association serving the orthopedic industry. Membership includes more than 1,600 orthopedic practice executives, administrators, physicians, and their staff. The association is loosely affiliated with the American Academy of Orthopaedic Surgeons (AAOS), dealing with the business side of orthopedic practices.

To study up on the MIPS program, click here.

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