In December 2015, I wrote about the Changes, Challenges and Opportunities we would see in 2016. Some things evolved as expected while others took some unanticipated turns. In December 2017, as we look ahead to 2018, once again there are changes, challenges and opportunities to consider.

Two years seems to be a popular lookback timeframe. The Quality Payment Program (QPP) within the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) provides for a two-year span between cause and effect in its impact on payment for health care services. As an example, Eligible Clinician (EC) 2017 performance in the Merit-based Incentive Payment System (MIPS) will impact the Medicare payments s/he receives in 2019. That two-year span was also seen in the QPP’s precursors: the Physician Quality Reporting System (PQRS), the Value-based Payment Modifier (VBM) and Meaningful Use (MU).

The...

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