CMS’ Physician QRUR Tables Highlight High-Value Referral Patterns for Medicare Population

William HoldingAmong other data, detail tables in a physician practice’s Quality Use and Resource Reports (QRURs) pinpoint specialist referral networks for Medicare beneficiaries, explains William Holding, consultant, PDA, Inc., which can help physician practices determine their highest value referral pathways.

In this audio interview, Holding explains the benefits of tapping CMS-generated QRUR reports to enhance performance under Merit-Based Incentive Payment Systems (MIPS), one of two payment paths for physician reimbursement under MACRA.

During Physician MACRA Preparation: Using QRUR and Other CMS Data To Maximize Your Performance, a January 2017 webinar now available for replay, Holding and colleague Nancy Lane, president of PDA, Inc., share the critical steps physician practices should take when analyzing their QRUR data, along with details on other CMS data points that can help practices improve MIPS performance.


Length: 3:07 minutes

Trends Shaping Healthcare for 2016: Rethink the Patient Experience in Response to Consumerism

Laura JacobsThe patient experience begins before an individual even thinks about going to the doctor or hospital, notes Laura Jacobs, executive vice president for GE Healthcare Camden Group, and patient satisfaction has moved beyond what is measured on surveys. As such, healthcare organizations should thoughtfully craft communications and care delivery strategies to meet rising consumer expectations and boost quality metrics. In this audio interview, Ms. Jacobs suggests how to better manage the consumer experience across the care spectrum and respond to the proliferation of consumer-generated healthcare data via apps and social media.

During a November 2015 webinar, Trends Shaping the Healthcare Industry in 2016: A Strategic Planning Session, now available for replay, Ms. Jacobs and Paul Keckley, managing director of Navigant, provided a roadmap to the key issues, challenges and opportunities for healthcare providers and payors in 2016.


Length: 3:35 minutes

Healthcare Performance Benchmarks: Diabetes Management

The use of a disease-specific approach to improve health outcomes and self-management for patients with diabetes is utilized by 77 percent of organizations, according to HIN’s 2011 survey on diabetes management programs. In this podcast, Melanie Matthews shares key metrics from the survey, including the role of the case manager, the use of incentives, the staff member responsible for diabetes management and the greatest challenge associated with the control of diabetes.

Also, Kathy Brieger, Hudson River HealthCare chief operating officer, describes HRHC’s four-pronged approach to weight management for the 3,400 adult patients it serves.

Need more information on this topic? Download an executive summary of the survey results.


Length: 3:02 minutes

Health Risk Assessments: Administration, Delivery and Completion Benchmarks

Who’s using health risk assessments (HRAs), and how are they administered? What are the top incentives driving HRA completion, and what are the top three uses for HRA data? What completion rates can be expected?

In this month’s healthcare benchmarks podcast, Healthcare Intelligence Network executive VP and COO Melanie Matthews shares the latest market research on HRA use. This month’s metrics are derived from HIN’s June 2010 survey on HRAs, with commentary from Dr. Marcia Wade, Aetna Medicare‚Äôs senior medical director.

More actionable data on ways that 116 healthcare organizations are using HRAs is contained in 2010 Performance Benchmarks in Health Risk Assessment Use, a 60-page resource providing metrics and measures on current and planned HRA initiatives as well as lessons learned and results from successful health assessment programs.




Length: 3:01 minutes