Clinical Quality and Payment

TMA Practice Consulting
Get personalized quality improvement services and tailored practice support to help your practice succeed under the Medicare Access and CHIP Reauthorization Act (MACRA).

MACRA Readiness Assessment
Identifies specific clinical processes, electronic health record optimizations, and workflow improvement opportunities to help practices improve MIPS scores. TMA is dedicated to helping practices earn incentive payments, not just avoid penalties. E-mail practice[dot]consulting[at]texmed[dot]org

TMF Networks improve health care quality across the continuum of care. Join a network to receive free assistance on quality improvement efforts in your practice or health care organization.

• Nursing Homes/Skilled Nursing Facilities
• Community Coalitions
• Patients, Families and Caregivers
• Quality Improvement Initiative
• Quality Payment Program

The Centers for Medicare & Medicaid Services (CMS) is auditing physicians who participated in the 2017 and/or 2018 Merit-Based Incentive Payment System (MIPS) under the Quality Payment Program. Guidehouse, a contracted entity, is conducting MIPS data validation and audits on behalf of CMS. If you’re selected for an audit, you are required to comply with data sharing requests, providing all data as requested.

If you participated in the 2018 Quality Payment Program, it’s now possible to check whether you’ll receive a Medicare payment bonus or cut in 2019. TMA recommends that you review your data to inform quality improvement efforts in your practice and to help you select the right quality measures, promoting interoperability measures, and improvement activities for 2019 and future years of the program, as well as to improve your performance on cost measures. For tips on how to improve your score, contact TMA Practice Consulting or TMF Health Quality Institute.

The shift to value-based payment models has not been easy on small practices. But new ideas within the Texas Medicaid program have spurred hope and excitement. Physicians, hospitals, and health plans are collaborating on innovations that not only could save millions, but also make medicine more patient-centered and more rewarding.

Learn about reimbursable care management services from the Centers for Medicare & Medicaid Services.

• Chronic Care Management Services
• FAQs about Physician Billing for Chronic Care Management Services
• Connected Care: The Chronic Care Management Resource
• Connected Care Toolkit
• Advanced Care Planning Services
• Behavioral Health Integration Services
• Transitional Care Management Services

Physicians looking for help navigating the Centers for Medicare & Medicaid Services requirements for the Quality Payment Program can benefit from TMF’s Quality Payment Program Network.