CMS recently proposed that healthcare providers on the MIPS payment track who attest to consulting a qualified CDSM across all advanced imaging orders in 2018 will receive credit towards their practice improvement activity. When integrated with a CEHRT, they can receive an additional Advancing-Care information score.
During 2018, the “cost” category score will also contribute to future payment adjustments. The cost component of MACRA will be calculated based on the overall Medicare Spend-per-Beneficiary using the Value Based Payment Modifier. A better score translates to more payment.
When considering a PAMA compliance strategy, managing utilization across all Medicare services will become increasingly important. A qCDSM with comprehensive AUC coverage and capabilities that impact utilization across all care settings, including pediatrics, becomes more important than ever.
CMS is telegraphing a stronger linkage between MACRA and the AUC provisions of PAMA. Further reinforcing the need for healthcare organizations to manage the overall utilization of services covered by Medicare using decision support tools in 2018.