MRO Viewpoints
Navigating the CMS 2025 Physician Fee Schedule Final Rule
The Centers for Medicare & Medicaid Services (CMS) 2025 Physician Fee Schedule (PFS) Final Rule brings notable updates to the Quality Payment Program (QPP), which will impact eligible clinicians, groups, virtual groups, subgroups, and APM entities. Whether you’re...
What is HEDIS? The Basics, Objectives and Significance
One of the most important tools utilized by payers across the country is the Health Effectiveness Data and Information Set (HEDIS), which is maintained by the National Committee for Quality Assurance (NCQA). HEDIS is a measurement set used to determine the efficacy of...
Why Your Final MIPS Score Might Be Different from What You Expected – and What You Can Do About It
If you’re participating in the Merit-based Incentive Payment System (MIPS) or MIPS Value Pathways (MVPs), you’ve likely encountered a familiar scenario: you review your estimated MIPS score in your dashboard, only to find that months later, when CMS releases the final...
Modern Efficiencies for a Modern Audit Team: MRO Experts Share How to Reduce Risk
Internal audits and monitoring are essential practices to ensure coding and billing compliance, protect revenue, and defend against payer audits and clinical denials. However, with limited time and resources, it becomes impossible to internally review every physician,...
Exploring the Future of Payer-Provider Data Exchange: Insights from MRO and CHIME’s Recent Research Report
As healthcare moves deeper into the digital age, the seamless exchange of clinical data between health systems and payers has become increasingly critical. Earlier this year, MRO in collaboration with the College of Healthcare Information Management Executives...
4 Reasons Why the Adoption of FHIR Brings Immense Value to Medical Record Requesters
What is FHIR? The HL7® FHIR® (Fast Healthcare Interoperability Resources) standard is the accepted standard for exchanging healthcare information, regardless of how or where the information is stored. By enabling secure access to both clinical and administrative data,...
The Power of Connection: How Clinical Data Registries, ACOs, and Payers Can Collaborate for Value-Based Care
Value-based care (VBC) is not new. The concept began in the 1980s with the introduction of managed care and capitation models, where providers were paid a set amount per patient rather than per service. However, it gained significant traction in the early 2000s and...
CMS Proposals for Healthcare Quality Reporting in 2025 and Beyond
In the rapidly evolving landscape of healthcare, staying ahead of regulatory changes and quality reporting requirements is crucial for both Accountable Care Organizations (ACOs) and clinicians participating in the Quality Payment Program (QPP). The Centers for...
Unraveling the Financial Ramifications of MSSP ACO Reporting
In the dynamic landscape of healthcare, where quality care and cost-effectiveness are paramount, initiatives like the Medicare Shared Savings Program (MSSP) play a pivotal role. As healthcare providers strive to deliver better outcomes while managing costs,...
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