Read the Latest Issue of STATLINE
August 2, 2016
In This Issue:
- Pathologists Earn Bonuses, Avoid Penalties by Reporting the CAP's PQRS Measures
- Course on MACRA, Medicare Payment for Pathologists Featured at CAP16
- CAP Opposes VA Proposal Expanding Practice Authority for APRNs
- Watch our Advocacy 101 Webinar: What Residents Need to Know
- Take Our STATLINE Readership Survey
Pathologists Earn Bonuses, Avoid Penalties by Reporting the CAP's PQRS Measures
According to the latest experience report on the Physician Quality Reporting System (PQRS), 86.3% of eligible pathologists earned a Medicare bonus by reporting quality measures developed by the CAP.
A total of 8,920 pathologists received a PQRS incentive bonus, according to a Centers for Medicare & Medicaid Services (CMS) report on the 2014 PQRS reporting year. Pathologists in 2014 earned $3.1 million by reporting PQRS measures developed by the CAP. Roughly $24 million in PQRS bonuses have been paid to pathologists since 2009.
In addition to earning PQRS bonuses, the vast majority of pathologists continue to avoid Medicare penalties by reporting measures developed by the CAP. In 2015, pathologists avoided $13.5 million in PQRS penalties by using the CAP's measures for pathology. According to the latest CMS PQRS experience report, 84% of pathologists are avoiding the PQRS penalty which reduces Medicare payment by 1.5% in 2016. By comparison, 68% of all eligible physicians will not receive the negative PQRS adjustment in 2016.
Quality reporting will remain an important aspect of the Medicare program. Quality reporting is a category under reforms that will create Medicare's Merit-based Incentive Payment System (MIPS). Reporting for MIPS begins in 2017 and MIPS Medicare payment adjustments take effect in 2019. The CAP is working to maintain its quality measures and evaluate opportunities for new measures for pathologists to report under the new program.
For more information on MIPS, watch the CAP's webinar on reimbursement reforms under the Medicare Access and CHIP Reauthorization Act (MACRA).
Course on MACRA, Medicare Payment for Pathologists Featured at CAP16
Registration is now open for key CAP policy and advocacy courses and roundtable discussions important to the pathology specialty during CAP16 in Las Vegas September 25-28.
Ensure you can attend "MACRA, Pay for Performance and the Physician Fee Schedule—You Can Run But You Can't Hide" (S1620) by registering and selecting this popular course today. During this featured presentation, attendees will learn the purpose of new pay-for-performance programs and delivery system reform culminating in the enactment and implementation of the Medicare Access and CHIP Reauthorization Act (MACRA). Experts will explain which pathologists are subject to, and ways to successfully participate in, the merit-based incentive payment system and alternative payment model pathways. The potential ramifications for not participating will also be discussed.
The session starts at 8 AM on Monday, September 26. Register for S1620 MACRA, Pay for Performance and the Physician Fee Schedule—You Can Run But You Can't Hide today.
Additional CAP advocacy courses and roundtable discussions are also available at CAP16:
- M1596 How is My Payment Determined for Pathology Services?
Sunday, September 25, 1-2 PM
- R1690 My Surgical Pathology and Cytopathology Coding Dilemmas: Getting It Right
Monday, September 26, Noon to 1 PM
- STA001 "How Data Drives CAP Advocacy: What Pathologists are Saying about the Economics of Pathology Practice"
Monday, September 26, 5:30-6:30 PM
- R1691 Current Payment Policy Challenges in Pathology Practice
Tuesday, September 27, Noon to 1 PM
CAP Opposes VA Proposal Expanding Practice Authority for APRNs
The CAP has opposed a Department of Veterans Affairs (VA) proposed regulation to permit full practice authority to all VA advanced practice registered nurses (APRNs). In a July 25 letter to the VA, the CAP stated the agency should not move forward with the proposed rule as written and cited concerns regarding the role of nurses in the performance and supervision of laboratory testing.
While the CAP supports the VA's efforts to address the challenges that exist within its health system, the College is deeply concerned that the proposal will allow advanced practice nurses to supervise the performance of laboratory tests, the CAP stated in the letter to the VA. The current CLIA Clinical Laboratory Personnel Requirements for General Supervisor requires specific laboratory training in laboratory science or medical laboratory technology and previous training and/or experience in high complexity testing. Nursing education and training are not an equivalent or appropriate substitute for laboratory science education and training and do not adequately prepare individuals for a technical or general supervisor role in a CLIA certified laboratory, the CAP said.
In addition, the CAP has also signed a letter led by the American Medical Association (AMA) to oppose the VA's proposed rule.
Watch our Advocacy 101 Webinar: What Residents Need to Know
View the recording of the CAP's Advocacy 101 for residents webinar. During this complimentary presentation, attendees received key information about the CAP's advocacy structure and policy agenda for pathologists and their patients.
Presenters Emily E. Volk, MD, MBA, FCAP, chair of the CAP Council on Government and Professional Affairs, and Joseph Sanfrancesco, MD, a member of the Residents Forum Executive Committee, led the discussion, which included:
- US health policy
- Medicare payment
- New health care payment models
The webinar archive of the presentation along with the slides can be viewed at your convenience.
Take Our STATLINE Readership Survey
The CAP invites STATLINE readers to take a quick study regarding STATLINE, our weekly federal and state advocacy e-newsletter. STATLINE, a CAP-member benefit, provides information on policy, legislation, and political action as well as economic and regulatory affairs that affect pathology and laboratory medicine. Your valuable feedback will allow us to evaluate and improve the e-newsletter to best meet your needs. This survey should take approximately 5-10 minutes to complete.
The CAP recognizes the value of your time and privacy. Please be assured that your individual information will be kept strictly confidential and your email address will not be distributed to anyone. All results are reported in aggregate format. If you need assistance, please email Lori Vernon at: firstname.lastname@example.org.
As a thank you for your time and feedback, we invite you to enter into a drawing to win one of three $100 Amazon.com gift cards. If you would like to enter, please enter your information at the end of the study.