Archive for the ‘Chronic Care Management’ Category

Infographic: Manage Chronic Disease with the EFST Model for Cultural Competence

November 19th, 2018 by Melanie Matthews

The challenges of serious illness are compounded when there are cross-cultural issues at play, according to a new infographic by Quality Interactions.

The infographic examines the essential questions to ask patients to foster culturally-sensitive healthcare that improves patient adherence and health outcomes.

In the sphere of value-based healthcare, chronic care management (CCM) is a critical component of primary care and population health management. Targeting the Triple Aim goals of better health and care for individuals while reducing spending, CCM is viewed as a stepping-stone to success under Medicare’s Quality Payment Program that launched January 1, 2017.

2017 Healthcare Benchmarks: Chronic Care captures tools, practices and lessons learned by the healthcare industry related to the management of chronic disease.

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Infographic: Medicare Enrollees with Multiple Chronic Conditions

September 19th, 2018 by Melanie Matthews

A small fraction of
Medicare enrollees with multiple chronic conditions drive a majority of Medicare spending. Moreover, these enrollees also drive an even greater percentage of hospital readmissions within 30 days of initial discharge—a metric targeted by policymakers as a symptom of wasteful spending, according to a new infographic by the California Health Care Foundation.

The infographic examines the share of Medicare activity by enrollees with multiple chronic conditions as well as the most common chronic conditions among Medicare enrollees.

In the sphere of value-based healthcare, chronic care management (CCM) is a critical component of primary care and population health management. Targeting the Triple Aim goals of better health and care for individuals while reducing spending, CCM is viewed as a stepping-stone to success under Medicare’s Quality Payment Program that launched January 1, 2017.

2017 Healthcare Benchmarks: Chronic Care captures tools, practices and lessons learned by the healthcare industry related to the management of chronic disease.

Get the latest healthcare infographics delivered to your e-inbox with Eye on Infographics, a bi-weekly, e-newsletter digest of visual healthcare data. Click here to sign up today.

Have an infographic you’d like featured on our site? Click here for submission guidelines.

Guest Post: The Provider’s Responsibility for Building Patient Relationships

July 31st, 2018 by Dr. Delanor Doyle

A foundational element of healthcare is the relationship between a patient and their PCP.

One of the foundational elements of healthcare is, or at least should be, the relationship between a patient and their primary care physician (PCP). And yet, it seems many Americans are not fully utilizing their PCP and instead are turning to emergency rooms or urgent care clinics for non-urgent conditions and illnesses. In fact, only 9 percent of emergency department visits result in a hospital admission. This means it is likely that many of these cases could have been avoided by seeking the care of a PCP.

Emergency department visits not only result in hefty costs to the patient and their employer, but also create wastes of time and resources in the healthcare system. The impact in terms of costs, for the patients can have many down-stream consequences. In fact, a recent report by the U.S. Federal Reserve found that four out of 10 adults in the United States could not cover an unexpected $400 expense. In some cases, this amount can easily be reached for a single emergency room visit between out-of-pocket costs for the visit, medications and laboratory services —especially when dealing with out-of-network issues. Providers should work to keep patients out of emergency rooms and urgent care facilities and to emphasize the importance and purpose of the PCP in the patient’s healthcare journey.

Until the 1940s, about 40 percent of all physician visits were house calls and while today patients don’t have this same expectation, providers should treat patients with that same level of personalized, individual care that builds a strong relationship. Providers can consider implementing the following best practices with their patients:

Every Discharge Deserves a Follow-Up

In many cases the PCP is not the provider who admitted or cared for the patient while in the hospital. However, it is imperative that the PCP insist on receiving information about the patient’s admission, so that he or she can be a part of the discharge plan. The patient should be seen back in the practice within three to five days after discharge —even if they were seen just prior to going into the hospital. In fact, this should be scheduled for the patient prior to hospital discharge. Timely follow-up appointments have been associated with a decreased risk of readmission. A converse association also exists. A study published in Clinical Interventions of Aging found only half of patients discharged following heart failure had a follow-up appointment scheduled and the readmission rate was significantly higher in those that had no follow-up scheduled.

Follow-up appointments allow for the provider to engage or re-engage the patient and ensures the patient is aware of any care transition recommendations. Concerns regarding disease process, expectations and convalescence should be addressed at this time. Working to schedule all patients for timely follow-up post discharge eliminates the risk of the patient forgetting to schedule the appointments themselves. Many patients report a higher sense of satisfaction with the communication between themselves and their provider and with their overall care.

Encourage Virtual Care Options

For after-hours needs, do your patients know there are virtual care options they can use in lieu of going to the emergency room or urgent care clinics for non-urgent concerns? Many patients are simply unaware of these services or aren’t sure how to use them so they don’t consider it as an option. According to the National Business Group on Health, only 8 percent of employees utilize telemedicine services, yet the cost of healthcare benefits is expected to increase an average of 5 percent due in part to pharmaceutical costs but also to site of service issues as well. Spend a few minutes during the visit to educate patients on the services available as well as when to use them.

Promote Health Plan Resources

Unfortunately, many patients are also not familiar with the services or programs offered by their health plans. These materials are good resources for preventative care measures and offer proactive suggestions for patients. For example, their insurance provider might offer diabetes educational materials and resources. Most health plans have programs for diabetes and other chronic conditions. If members are encouraged to access the materials available online, telephonically and in print they might be more likely to seek out that information and if contacted by the health plan they will be much more likely to engage. It is important that patients begin to get a sense that the health plan and the providers are collaborating for the patient’s benefit.

We are still in a fee-for-service world but moving toward fee-for-value. This is being driven by the Centers for Medicare and Medicaid Services (CMS) and all the major health plans. To be successful in this new world, improved patient outcomes should be a major focus for providers. Strategies that engage the patient and simplify the healthcare experience when and where it is needed most are going to be produce the winners in this new era. The literature is replete with strategies that can produce population health success, but few are shown to be consistently correlated to economic success combined with improved patient satisfaction and outcomes. The exceptions have been those that employ heavy care coordination in a face-to-face venue and that address the social determinants of disease.

Fully leveraging these strategies is going to require the development of trust between the patient and provider so that patients know we are not just treating a disease but caring for the whole person. When that level of trust is reached it becomes easier to influence utilization of the PCP practice and other more appropriate levels of care instead of the ED. Similarly, it becomes easier to impact the readmission rate in one’s own panel of patients.

About the Author:

Dr. Delanor Doyle

Dr. Delanor Doyle

Dr. Delanor Doyle is the chief medical officer of Texas Health Aetna. Leveraging the strengths of two leading organizations, Texas Health Aetna is blurring the lines of traditional health care plans and health systems to create a truly integrated solution that’s simple to navigate and puts the member’s experience first. The local health plan is committed to providing affordable, high-quality health care services and delivering customized care to members throughout the Dallas-Fort Worth metroplex. For more information about Texas Health Aetna, visit www.texashealthaetna.com.

Infographic: Chronic Care Management Results

March 26th, 2018 by Melanie Matthews

The Chronic Care Management program through the Centers for Medicare and Medicaid Services (CMS) has produced significant positive changes during its first two years, according to a recent report by CMS researchers, Evaluation of the Diffusion and Impact of Chronic Care Management (CCM) Services: Final Report.

A new infographic by CareSync highlights the results of the CMS report, including benefits to healthcare providers, payers, and patients.

In the sphere of value-based healthcare, chronic care management (CCM) is a critical component of primary care and population health management. Targeting the Triple Aim goals of better health and care for individuals while reducing spending, CCM is viewed as a stepping-stone to success under Medicare’s Quality Payment Program that launched January 1, 2017.

2017 Healthcare Benchmarks: Chronic Care captures tools, practices and lessons learned by the healthcare industry related to the management of chronic disease.

Get the latest healthcare infographics delivered to your e-inbox with Eye on Infographics, a bi-weekly, e-newsletter digest of visual healthcare data. Click here to sign up today.

Have an infographic you’d like featured on our site? Click here for submission guidelines.

Essentia Health Virtual Telemedicine Services Support Rural Hospitals and Clinics

March 13th, 2018 by Patricia Donovan

Essentia Health conducts 5,000 virtual visits annually.

There may be some challenges associated with Essentia Health’s comprehensive telemedicine program, but provider engagement isn’t one of them.

“In the seven years I have been with Essentia Health, I have not gone to any provider to ask them to do telehealth,” notes Maureen Ideker, RN, BSN, MBA, the organization’s senior advisor for telehealth. Instead, physicians seek out Ms. Ideker, asking to be connected to any of Essentia Health’s six hospital-based and more than 20 clinic-based telehealth services.

Such robust telemedicine adoption among Essentia Health’s more than 800 physicians may be one reason why the organization averages 5,000 virtual visits annually, and why it has another 10 to 20 new telehealth offerings in development, according to Ms. Ideker’s presentation during Telemedicine Across the Care Continuum: Boosting Health Clinic Revenue and Closing Care Gaps.

The largely rural footprint of Essentia Health, which touches the three states of Minnesota, Wisconsin and North Dakota, is ideally suited to telehealth implementation. During this March 2018 webinar, which is now available for rebroadcast, Ms. Ideker outlined her organization’s telehealth program models, history of program development, and equipment and staffing requirements. She also shared key program outcomes, such as the impact of remote patient monitoring on hospital readmissions and clinic ROI from telehealth.

For example, the 30-day readmission rate for Essentia Health patients with heart failure remotely monitored at home is 2 percent, versus its non-monitored heart failure patients (9 percent) and the national 30-day readmissions average of 24 percent.

Essentia Health’s hospital-based telemedicine began with an emergency room platform, which includes pediatric ER and pharmacy and toxicology and a soon-to-be-added behavioral health component. Today, hospitalist and stroke care are the largest of Essentia Health’s hospital-based telemedicine programs, explained Ms. Ideker. These virtual services support Essentia Health’s rural hospitals in five key ways, including the avoidance of unnecessary patient transfers.

On the outpatient side, the 20-something tele-clinic based services developed by Essentia Health over the last seven years run the gamut from allergy and infant audiology to urology and vascular conditions, she explained. Her organization’s telemedicine approach to opioid tapering is catching on across Minnesota, she added.

And while it is appreciative of its providers’ enthusiasm, Essentia Health approaches telehealth development with precision, consulting data analytics such as metrics on annual health screenings to create target groups for new services. The launching of a new telemedicine service can take up to twelve weeks, using a 75-item checklist and an implementation retreat and walk-through, Ms. Ideker explained.

In closing, Ms. Ideker shared several innovation stories from its portfolio of telehealth offerings, including Code Weather, employed during hazardous weather for patient safety reasons and to reduce cancellations of appointments, and a gastroenterology initiative designed to reduce no-show rates.

Listen to Maureen Ideker explain how Essentia Health pairs remote patients with hospital- and clinic-based telehealth services.

Population Health Tactics to Boost an ACO’s Medicare Annual Wellness Visit Rates

February 9th, 2018 by Patricia Donovan

One of the most important revenue opportunities for primary care physicians, and for population health nurses under their direct supervision, is the Medicare Annual Wellness Visit (AWV), advises Tim Gronninger, senior vice president of development and strategy, Caravan Health. The AWV offers an opportunity to check a number of Medicare quality boxes, including preventive check-ins, vaccinations and health screenings, to help make sure that a beneficiary’s medical needs are being met.

Here, Gronninger suggests ways that physician practices can improve all-important AWV rates.

Much of increasing annual wellness visit rates is about how to manage expectations of the practice and of the patient. You’ll be chasing your tail a lot if you are looking at your data and saying, “Well, these 1,000 patients haven’t had an annual wellness visit. I’m going to make a thousand phone calls, and then I’m going to make a thousand follow-up phone calls to try to schedule them all.”

It is very important for a practice to create a process where you have the time, the space and the plan, so that when a patient comes in the door for an Evaluation and Management (E&M) visit, the patient is handed off seamlessly to a nurse coordinator to complete an annual wellness visit at the same time. Obviously, different patients will require different handling. But we have found a very high acceptance rate from that approach among patients of clients that we work with.

It’s something that many patients take for granted, that their clinician knows this about them already. However, many times, the physician in practice doesn’t know whether the patient is up to date on their mammograms or other types of screenings.

Editor’s Note: Caravan Health’s ACOs saved more than $26 million in the Medicare Shared Savings Program (MSSP) and achieved higher than average quality scores and quality reporting scores in 2016.

Source: Profiting from Population Health Revenue in an ACO: Framework for Medicare Shared Savings and MIPS Success

ACO population health

Profiting from Population Health Revenue in an ACO: Framework for Medicare Shared Savings and MIPS Success examines Caravan Health’s population health-focused approach for ACOs and its potential for positioning ACOs for success under MSSP and MACRA’s Merit-based Incentive Payment System (MIPS).

8 Findings from CMS Medicare Chronic Care Management Assessment

January 26th, 2018 by Patricia Donovan

YNHHS embedded care coordination

Medicare Chronic Care Management services reduced healthcare utilization and likelihood of hospital admissions for CCM recipients, according to a new CMS report.

Beneficiaries who received Chronic Care Management (CCM) services experienced a lower growth rate in healthcare expenditures compared to those who did not receive CCM services, according to a new evaluation report from the Centers for Medicare and Medicaid Services (CMS).

The lower rate of growth in total Medicare per beneficiary per month (PBPM) expenditures ranged from $28 to $74, after removing the average monthly CCM fee of $29.

The Medicare and Medicaid payor released the report on the diffusion and impact of CCM payment during the program’s first two years of implementation.

In January 2015, CMS introduced a separately billable non-face-to-face Chronic Care Management service (CPT code 99490). The goal of CCM is to improve Medicare beneficiaries’ access to chronic care management in primary care.

Here are seven more findings from the evaluation report:

  • Over 684,000 beneficiaries received CCM services from January 2015 to December 2016, the first two years of the new payment policy.
  • The decreased rate of growth was driven by decreases in expenditures for inpatient hospital services, skilled nursing facility services, and outpatient services; the decreased expenditures were partially offset by increased expenditures of home health and professional services. Researchers similarly found a lower rate of growth among CCM beneficiaries in hospitalizations and all-cause emergency department visits.
  • Receipt of CCM services was also associated with a reduced likelihood of an admission for the ambulatory care sensitive conditions of diabetes, congestive heart failure, urinary tract infection, and pneumonia among CCM beneficiaries, relative to the comparison beneficiaries.
  • A total of 16,549 individual healthcare providers billed for a total of $105.8 million in CCM fees in the first two years of the new payment policy.
  • Chronic Care Management beneficiaries were generally concentrated in the South and had poorer health status than the general Medicare fee-for-service (FFS) population.
  • About 19 percent of beneficiaries only received one month of CCM services; however the majority of beneficiaries received between four and ten months of CCM services, on average.
  • Primary care physicians (PCPs) billed for 68 percent of CCM claims and 42 percent of CCM billers were solo practitioners. Individual providers billed for $105.8 million in CCM fees during the first 24 months of the program and, on average, managed about 47 patients per month. However, the median number of patients was 10, indicating that the average was skewed by a small number of providers delivering CCM services to many beneficiaries. This translates to about $300 in CCM fees per month for providers furnishing CCM services to 10 beneficiaries.

The report did not examine the impact of 2017 CCM policy revisions that significantly increased payment for providing CCM to more medically complex patients.

Read the complete CMS Chronic Care Management evaluation report.

In Successful ACOs, Population Health Focus Paves Way for Shared Savings Payouts

January 25th, 2018 by Patricia Donovan

Physician practices toiling in fledgling ACOs and obsessing over shared savings that have not yet materialized, take heart: population health offers multiple revenue streams for accountable care organizations waiting for the “gravy” of accountable care.

“Gravy” is the way Tim Gronniger, senior vice president of development and strategy for Caravan Health, refers to ACO shared savings payouts, which he says can take considerable time to accrue.

“It is literally two years from the time you jump into an ACO before you have even the chance of a shared savings payout,” Gronniger told participants in Generating Population Health Revenue: ACO Best Practices for Medicare Shared Savings and MIPS Success, a January 2018 webcast now available for replay.

Obsessing over shared savings is one of the biggest mistakes hospitals in ACOs can make, he added.

This delay is one reason Caravan Health urges its ACOs to adopt a population health focus, whether pursuing the Centers for Medicare and Medicaid Services (CMS) Quality Payment Program (QPP) Merit-based Incentive Payment System (MIPS) or the Medicare Shared Savings Program (MSSP).

Gronniger’s advice is predicated on his organization’s experience of mentoring 38 ACOs. In 2016, Caravan Health’s ACOs saved more than $26 million in the MSSP program and achieved higher than average quality scores and quality reporting scores, according to recently released CMS data.

Walking attendees through a MACRA primer, Gronniger underscored the challenges of the MIPS program, one of three tracks offered under the Quality Payment Program. “Barring a really exceptional performance on MIPS, you can’t even break even over the next few years on physician compensation,” he said.

In the meantime, ACOs should utilize recently rolled out Medicare billing codes, from the annual wellness visit (AWV) to advanced care planning, to generate wellness revenue. With proper planning, reengineering of staffing and clinical work flows, a practice could generate anywhere from five hundred to one thousand dollars annually per eligible Medicare patient, Gronniger estimates—monies that offset the cost of constructing a sustainable ACO business model.

To back up this population health rationale, Gronniger pointed to data from an ACO client demonstrating the impact of a cohesive PHM approach, including the use of trained population health nurses, on completion rates for preventive screenings. For less top-of-mind screenings like falls assessment and smoking cessation, completion rates rose from negligible to near-universal levels, he said.

“These are recommended sets of screens that are required by CMS, but that also help ACOs with quality measures,” he added.

Gronniger also shared examples of dashboards, scorecards and roadmaps Caravan Health employs to help keep client ACOs on track. An ACO success strategy involves “a lot of dashboarding, checking in, and discussion of problems and barriers, discussion of solutions, and monthly and quarterly measurement and reporting back,” he said.

Beyond coveted shared savings, ACO participation offers significant non-financial benefits, including quality improvements under both MSSP and MIPS standards, availability of ACO-specific waivers, and access to proprietary performance data.

Overall, ACO participation can make providers more attractive both to commercial contractors and to potential patients perusing Physician Compare ratings in greater numbers.

Gronniger ended by weighing in on the recent recommendation by the Medicare Payment Advisory Commission (MedPAC) to repeal and replace the MIPS program.

Guest Post: Patient Engagement Technology Tool for Preventing Hospital Readmissions in Chronic Patients

January 23rd, 2018 by Allison Hart, Vice President of Marketing, TeleVox Solutions at West

While almost all chronic care patients say they need help managing their disease, less than one-third receive regular check-ins from healthcare providers.

During the past decade, the Centers for Medicare and Medicaid Services have increased the pressure on hospitals to prevent readmissions. In response to that pressure, many hospitals made changes that have led to declines in readmission rates. However, even with more measures in place to prevent readmissions than ever before, the risk of being readmitted to the hospital is still high for patients with chronic illnesses.

Studies have shown that the risk of adverse health effects increases with each hospitalization. Unfortunately, it can be difficult to keep chronic patients from readmitting once they have been hospitalized. Because of this, it is important that healthcare teams prioritize chronic disease management, and work to engage and support chronic patients. One tool that can help with this is the patient engagement technology many healthcare teams already have in place.

Survey responses indicate that chronic patients welcome efforts from their healthcare team that are aimed at managing disease and preventing hospital admissions and readmissions. A West survey found that 91 percent of chronic patients say they need help managing their disease, and at least 70 percent would like more resources or clarity on how to manage their condition. Additionally, 75 percent of chronic patients want their healthcare provider to touch base with them regularly so they can be alerted of potential issues.

Although patients with chronic conditions have expressed that they desire more assistance from their healthcare providers, they are not necessarily receiving it. For example, more than half (54 percent) of patients feel a weekly or twice-weekly check-in from their provider would be valuable, yet only 30 percent of patients report receiving regular check-ins. This shows that, in some cases, providers could be doing much more to offer ongoing chronic disease management support.

Providers seem to be underestimating patients’ interest in chronic care and their desire to receive support. Patients have suggested that they not only want assistance with managing chronic conditions, they would also be willing to pay for that extra support. Many providers are unaware that their patients feel this way. When asked if their patients would agree to pay 10 dollars per month for additional chronic care support, just over half (53 percent) of providers answered “yes.” However, two-thirds of patients say they would be willing to pay a nominal amount for chronic care support. The eye-opening response from patients confirms that chronic disease management is in demand—more so than providers realize. It also suggests that some providers may need to do more to offer ongoing chronic disease management support.

Chronic Care Management Enrollment

One way healthcare teams can better serve chronic patients and potentially prevent readmissions is by enrolling patients in chronic disease management programs. Chronic care programs, like Medicare’s Chronic Care Management program, require a lot of communication on the part of the healthcare team. Automating some of the communication and outreach makes it easier for providers to offer ongoing chronic care support. Healthcare teams can use their patient engagement technology to:

  • Send patients messages to invite them to enroll in a chronic care program. Using information from electronic health records, healthcare teams can identify patients that are eligible for chronic care management programs. (Patients must have two or more chronic conditions to enroll in Medicare’s Chronic Care Management program.) Then, they can use their patient engagement technology to send patients automated messages with information about the benefits of participating in a chronic care program, and instructions or links for patients to enroll or get further information.
  • Schedule disease-specific preventive screenings and tests. The Chronic Care Management program mandates that patients receive recommended preventive services. Care managers can schedule and send patients automated text messages, emails or voice messages to notify them when they are due for preventive screenings and tests. Patients with diabetes, for example, would automatically receive messages when they are due for an A1C test, foot exam or eye exam.
  • Send medication reminders and messages. Providers are required to manage and reconcile medications for patients enrolled in the Chronic Care Management program. Providers can assign medication reminders and send automated messages to ensure patients know how and when to take their medication, and that they don’t forget to take it.

Communication that engages chronic patients and aids them in disease management can result in better health outcomes and fewer readmissions. Engagement communications can be easily automated, meaning outreach does not require excessive time or resources. Hospitals and healthcare providers have incentives to reduce readmissions, and in many cases, they have the technology in place to make chronic disease management efficient and effective.

About the Author: Allison Hart is a regularly published advocate for utilizing technology-enabled communications to engage and activate patients beyond the clinical setting. She leads thought leadership efforts for West’s TeleVox Solutions, promoting the idea that engaging with patients between healthcare appointments in meaningful ways will encourage and inspire them to follow and embrace treatment plans – and that activating these positive behaviors ultimately leads to better outcomes for both healthcare organizations and patients. Hart currently serves as Vice President of Marketing for TeleVox Solutions at West, where the healthcare mission is to help organizations harness communications to expand the boundaries of where, when, and how healthcare is delivered.

HIN Disclaimer: The opinions, representations and statements made within this guest article are those of the author and not of the Healthcare Intelligence Network as a whole. Any copyright remains with the author and any liability with regard to infringement of intellectual property rights remain with them. The company accepts no liability for any errors, omissions or representations.

Assessing MIPS’ Fate: “MedPAC Vote Would Not Affect 2018 Under Any Scenario”

January 18th, 2018 by Patricia Donovan

Tim Gronniger

Tim Gronniger, Senior VP of Development and Strategy, Caravan Health

Amidst healthcare provider outcry over last week’s vote by the Medicare Payment Advisory Commission (MedPAC) to repeal and replace the Merit-based Incentive Payment System (MIPS), an industry thought leader sought to remind physician groups that no change to MIPS is imminent.

“MedPAC is an advisory body, not a legislative one,” said Tim Gronniger, senior vice president of development and strategy for Caravan Health, a provider solutions for healthcare organizations interested in value-based payment models, including accountable care organizations (ACOs).

“Congress would need to adopt MedPAC’s recommendations in order for the changes to go into effect. It is reasonable to expect MIPS to evolve over time, but that evolution will be gradual. [MedPAC’s vote on MIPS] would not affect 2018 under any scenario.”

Gronniger made his comments during Generating Population Health Revenue: ACO Best Practices for Medicare Shared Savings and MIPS Success, a January 2018 webcast sponsored by the Healthcare Intelligence Network and now available for rebroadcast.

Earlier this month, MedPAC voted 14-2 to scrap the MIPS program, describing it in a presentation to members as “burdensome and complex.” According to the advisory commission, “MIPS will not succeed in helping beneficiaries choose clinicians, helping clinicians change practice patterns to improve value, or helping the Medicare program to reward clinicians based on value.”

MedPAC is expected to pass this recommendation along to Congress in coming months, along with a proposed alternative. In MIPS’s place, MedPAC is suggesting a voluntary value program (VVP) in which “group performance will be assessed using uniform population-based measures in the categories of clinical quality, patient experience, and value.”

MGMA’s Anders Gilberg reacts to the MedPAC ruling.

Among the provider groups reacting to MedPAC’s actions was the Medical Group Management Association (MGMA). In a Twitter post, Anders Gilberg, MGMA’s senior vice president for government affairs, called the VVP alternative “a poor replacement,” claiming it “would conscript physician groups into virtual groups and grade them on broad claims-based measures.”

The day prior to the January 11 vote, MGMA had reached out in a letter to Seema Verma, administrator for the Centers for Medicare & Medicaid Services (CMS), requesting CMS to immediately release 2018 Merit-based Incentive Payment System (MIPS) eligibility information, which it called “vital to the complex clinical and administrative coordination necessary to participate in MIPS.”