MRO Viewpoints
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,...
Elevate Your Quality Scores: A Guide to Maximize MIPS/MVP in 2024
As the healthcare landscape continues to evolve, so do the challenges and opportunities presented by CMS’ Quality Payment Program (QPP). Since its inception in 2017, QPP has become increasingly complex, making it harder for providers to avoid penalties and maximize...
How Data Builds New Bridges Between Payers and Providers: CareFirst Highlighted by HealthLeaders
Forward-thinking payer and provider organizations continually seek new ways to foster collaboration and improve relationships despite tumultuous exchanges between the two parties. Better communication helps both stakeholders reduce administrative costs and improve...