Within the US Department of Health and Human Services, there exists a well-reputed federal agency, which is known as the Centers for Medicare and Medicaid Services (CMS). It supervises every single initiative or program pertaining to Medicare. CMS also functions as a partner of state governments to manage and improve the standards of the Children’s Health Insurance Program and portability besides Medicaid.
Apart from the aforementioned ones, CMS is also responsible for administrating quality standards in clinical labs and nursing homes by conducting a survey and certification procedure. In addition, the agency ensures health coverage to over a hundred million individuals through various programs.
The main objective of CMS is to make the United States’ healthcare system more robust and advanced. Attaining this will enable it to provide top-notch medical care services at lower prices. Authorized employees at this federal agency obtain and analyze valuable data and generate research reports besides devising strategies to deter fraudulent activities within the healthcare system.
Reason Why CMS is In the News
The community of certified medical care professionals has lately identified certain issues. It expressed concerns related to the scores and feedback on healthcare providers’ performance. The Centers for Medicare and Medicaid Services is in charge of monitoring and evaluating how physicians are performing their duties. The agency makes payment of incentives to doctors after analyzing their performance and ranking each of them on the basis of merit.
While conducting the last performance review process, CMS made a couple of unmistakable errors, which the agency even published without noticing and correcting. The moment physicians or clinicians discovered the mistakes, they immediately informed the agency about the same.
The already released final scores and feedback on doctors’ performance by CMS massively disappointed the physician community. Therefore, they started raising their concerns and demanded that CMS must correct MIPS scores and change its comment on providers’ performance at the earliest. Subsequently, the community of health care practitioners has compelled the federal agency to correct and re-release the 2020 final results and make necessary payment adjustments for 2020.
Take of CMS on the Physician Community’s Concerns
The chief PR executive at CMS expressed how the federal organization views the physicians’ prevailing concerns related to incentive payment program and steps they would take to resolve the issue. It was also said that CMS’ goals since the advent of QPP have been forming a fully-transparent program and providing correct and precise information. The PR head indicated that CMS would correct errors that it committed and were pointed out by clinicians as soon as possible.
How Has CMS Planned to Proceed?
CMS is now looking forward to working in close association with the community of health care professionals to accomplish its goal. Also, doing so will help both the agency and community to acquire knowledge from each other aside from improving operational standards in implementation.
The Centers for Medicare and Medicaid Services is currently making requisite amendments to the incentive payment system. CMS has found out that MIPs-eligible doctors who have participated in Medicare Shared Savings Program Accountable Care Agencies were not provided with bonuses in their final reports to ensure the treatment to patients with complex medical conditions.
To mitigate this major error, as compensation, the agency intends to grant up to ten bonus scores while re-publishing providers’ performance feedback and final points. The federal organization also admitted that it failed to recognize patient-reported results correctly, which is why it has now started correcting the scores besides changing spelling for around thirty thousand MIPS-eligible clinicians.
CMS officials have already said that most doctors would see a slight improvement in their performance score and ultimate MIPS ranking. However, they also mentioned that about four thousand and four hundred clinicals would see a reduction.
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