Archive for the ‘Physician Practices’ Category

Infographic: Which Physician Quality Payment Program Is Right for You?

September 19th, 2016 by Melanie Matthews

For Medicare physicians and groups that will be impacted by the new Merit-Based Incentive Payment Program (MIPS) and the Advanced Alternative Payment Model (APM) requirements, it is important to remember that planning for the Quality Payment Program is more nuanced than simply 'selecting a track,' according to a new infographic by Able Health.

To help make understanding the two Quality Payment Program tracks a bit easier, Able Health's infographic helps physicians and medical groups determine which track may be the most appropriate to prepare for in 2017.

No matter which level of participation physician practices choose for the first Quality Payment Program performance period beginning January 1, 2017, CMS's "Pick Your Pace" announcement means practices should proactively prepare for the impact of the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) on physician quality reporting and reimbursement.

MACRA Physician Quality Reporting: Positioning Your Practice for the MIPS Merit-Based Incentive Payment System delivers a veritable MACRA toolkit for physician practices, with dozens of tips and strategies that lay the groundwork for reimbursement under Medicare's Merit-based Incentive Payment System (MIPS), expected to begin in 2017 and one of two payment paths Medicare will offer to practices.

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5 Ways to Keep Pace with MACRA Momentum

September 15th, 2016 by Patricia Donovan

carecompactsIn a nod to the wide diversity of physician practices, the recent "Pick Your Pace" announcement by the Center for Medicare and Medicaid Services (CMS) clarifies the timing of reporting for year one of the Quality Payment Program and offers eligible physicians and other clinicians multiple options for participation.

But whatever participation level a practice elects for 2017, there are many ways eligible providers can proactively prepare for MACRA's ultimate impact on physician quality reporting and reimbursement prior to November 1, 2016, the date by which CMS has said it will issue the MACRA final rule.

Eric Levin, director of strategic services, McKesson, offered this advice for physician practices to prepare for Medicare's Merit-based Incentive Payment System (MIPS), one of two payment paths CMS will offer to practices.

  • First, make certain you are successfully participating in any Medicare Quality and electronic health record (EHR) programs, which would include the Physician Quality Reporting System (PQRS), Meaningful Use, and the Patient-Centered Medical Home.
  • Next, try and factor the alternative payment model (APM) participation bonus into your risk-based payment model adoption strategy to see if that might be something you can qualify for, as the rewards can be significantly higher under the APM track.
  • Third, make sure you know which track your organization is going to seek. Explore APMs; if you can do one, great. If not, then MIPS can still provide a relatively high incentive.
  • Next, start educating providers, employers, nurses, staff members, on what the payment track is going to be, what’s going to be measured, and what the outcomes will be like as well.
  • Finally, stay very close to CMS. Check their Web site, subscribe for e-mail updates and check their Twitter feed for anything that’s changed, for any proposed MACRA rules that might become final, so that you are aware of and can make any changes as needed.
  • Source: MACRA Physician Quality Reporting: Positioning Your Practice for the MIPS Merit-Based Incentive Payment System

    http://hin.3dcartstores.com/Post-Acute-Care-Trends-Cross-Setting-Collaborations-to-Align-Clinical-Standards-and-Provider-Demands_p_5149.html

    MACRA Physician Quality Reporting: Positioning Your Practice for the MIPS Merit-Based Incentive Payment System delivers a veritable MACRA toolkit for physician practices, with dozens of tips and strategies that lay the groundwork for reimbursement under Medicare's Merit-based Incentive Payment System (MIPS), expected to begin in 2017 and one of two payment paths Medicare will offer to practices.

Infographic: What Can a Nurse Practitioner do?

August 31st, 2016 by Melanie Matthews

Nurse practitioners may help to fill staffing needs at hospitals, physician practices and other healthcare organizations, according to a new infographic by Barton Associates.

The infographic looks at how nurse practitioners can practice at the top of their license.

A profitable by-product of CMS's aggressive pursuit of value-based healthcare delivery is a menu of revenue opportunities associated with care management of the Medicare population.

Physician Reimbursement in 2016: 4 Billable Medicare Events to Maximize Care Management Revenue and Results details the ways in which Bon Secours Medical Group (BSMG) leverages a team-based care approach, expanded care access and technology to capitalize on four Medicare billing events: transitional care management, chronic care management, Medicare annual wellness visits and advance care planning.

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Infographic: 5 Tips to Empower Medical Practice Staff

August 26th, 2016 by Melanie Matthews

Medical practice staff plays a pivotal role in shaping the patient experience, according to a new infographic by Specialdocs.

The infographic examines five key steps in empowering medical practice staff.

Healthcare Trends & Forecasts in 2016: Performance Expectations for the Healthcare IndustryPatient-centric interventions like population health management, health coaching, home visits and telephonic outreach are designed to engage individuals in health self-management—contributing to healthier clinical and financial results in healthcare's value-based reimbursement climate.
But when organizations consistently rank patient engagement as their most critical care challenge, as hundreds have in response to HIN benchmark surveys, which strategies will help to bring about the desired health behavior change in high-risk populations?

9 Protocols to Promote Patient Engagement in High-Risk, High-Cost Populations presents a collection of tactics that are successfully activating the most resistant, hard-to-engage patients and health plan members in chronic condition management. Whether an organization refers to this population segment as high-risk, high-cost, clinically complex, high-utilizer or simply top-of-the-pyramid 'VIPs,' the touch points and technologies in this resource will recharge their care coordination approach.

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Appointment Data Opens Door to Population Health Management of Rising Risk Patients

August 9th, 2016 by Patricia Donovan

The rising risk population represents a healthcare organization's "low-hanging fruit," says Dr. Adrian Zai, clinical director of population informatics at Massachusetts General Hospital.

Sometimes the most powerful population health management intervention is simply to convince a patient to make an appointment.

This is the first step Dr. Adrian Zai, clinical director of population informatics at Massachusetts General Hospital (MGH), would recommend to any organization hoping to better manage its rising risk population, a group the physician describes as "low-hanging fruit."

"The appointment does not require significant investment in any health IT or other resources," said Dr. Zai during Targeting High-Risk and Rising-Risk Patients: A Multi-Pronged Strategy, an August 2016 webinar now available for replay. "All you need is appointment data. The key is to identify existing data you already have in your organization and start there, so that you impact outcomes."

Dr. Zai, whose hospital has been ranked number one in the nation by U.S. News & World Report, likened the notion of an organization acquiring a sophisticated health data analytics system prior to identifying clinical outcomes to "building a house without an architect."

However, having done its due data diligence, MGH's population health management approach embraces technology. The MGH approach, which targets rising- and high-risk patients, has moved far beyond appointment-setting, constructing a safety net program with the goal of improving clinical outcomes for 300,000 patients in its entire primary care network— a network spanning MGH and Brigham and Women's Hospital.

To this end, MGH developed a new set of clinically meaningful measures, but not before soliciting physician feedback on its existing set. In response, doctors identified more than 200 challenges to the old measures that MGH addressed in its new decision support system.

With new measures in place, MGH then created central population health coordinator teams to support primary care physicians in population health management, freeing clinicians to care for patients.

The selection of technology to support MGH's primary care safety net presented its own challenges. "Frequently, the tools you end up with—for data aggregation, analytics, care coordination, and patient outreach—don't actually talk to each other. You need a system to pull all of these functionalities together. That's the strategy we took," said Dr. Zai.

The new MGH population health management system enables clinicians to identify and share gaps in care with MGH care coordinators and population health managers, so they can intervene and try and close those gaps, he continued.

The system also tracks outcomes. After using the system for only six months, MGH reported improvement in every one of its newly developed performance framework measures. Not only is the ability to review outcomes appealing to payors, but 85 percent of MGH physicians surveyed also expressed satisfaction with the system—as well as its concurrent financial incentives.

In closing, Dr. Zai reiterated the need for collaboration: between staffers doing the work and the informatics tying those efforts neatly together. "One cannot work without the other. That technology is just a tool. Just as you cannot give a hammer to someone and expect them to build a house, you need the talents working together with technology to make that happen."

Click here to listen to an interview with Dr. Zai on reducing the natural inertia of low-risk patients to move into the high-risk stratum.

Infographic: Building a Million-Dollar Physician Relationship

August 1st, 2016 by Melanie Matthews

In today's competitive healthcare environment, hospitals and health systems are looking to drive patient volume and attract and retain physicians, according to a new infographic by Evariant.

According to Evariant, the financial results of physician relationship management are compelling: A single physician, whether in primary care or a specialty, can generate more than $1.5 million in revenue each year, so it's a heavy price when referrals and procedures are lost to competitors.

The infographic drills down on how to build an effective physician relationship management strategy.

A profitable by-product of CMS's aggressive pursuit of value-based healthcare delivery is a menu of revenue opportunities associated with care management of the Medicare population.

Physician Reimbursement in 2016: 4 Billable Medicare Events to Maximize Care Management Revenue and Results details the ways in which Bon Secours Medical Group (BSMG) leverages a team-based care approach, expanded care access and technology to capitalize on four Medicare billing events: transitional care management, chronic care management, Medicare annual wellness visits and advance care planning.

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Infographic: Telemedicine in the Physician Practice

July 8th, 2016 by Melanie Matthews

Telemedicine is quickly changing the medical practice landscape as states, insurers and employers are making it a viable option for patients. Practitioners, patients and even employers stand to gain from the many benefits of telemedicine, according to a new infographic by Chiron Health.

The infographic examines why practices should offer telemedicine, which states reimburse for telemedicine and patient interest in telemedicine.

Real-time remote management of high-risk populations curbed hospitalizations, hospital readmissions and ER visits for more than 80 percent of respondents and boosted self-management levels for nearly all remotely monitored patients, according to 2014 market data from the Healthcare Intelligence Network (HIN).

Remote Monitoring of High-Risk Patients: Telehealth Protocols for Chronic Care Management profiles a successful eight-year initiative by New York City Health and Hospitals Corporation's (NYCHHC) House Calls Telehealth Program that significantly lowered patients' A1C blood glucose levels.

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Infographic: The Millennial Physician Mindset

July 4th, 2016 by Melanie Matthews

Some 59 percent of millennial physicians believe that being a millennial impacts their practice approach, usually with a more collaborative relationship with their patients, according to a new infographic by the Health Experience Project.

The infographic examines how millennial physicians engage their patients and the type of support that millennial physicians want from pharmaceutical companies.

A profitable by-product of CMS's aggressive pursuit of value-based healthcare delivery is a menu of revenue opportunities associated with care management of the Medicare population.

Physician Reimbursement in 2016: 4 Billable Medicare Events to Maximize Care Management Revenue and Results details the ways in which Bon Secours Medical Group (BSMG) leverages a team-based care approach, expanded care access and technology to capitalize on four Medicare billing events: transitional care management, chronic care management, Medicare annual wellness visits and advance care planning.

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CMS to Physicians: 3 Things You Really Need to Know About MACRA

June 20th, 2016 by Patricia Donovan

It is expected that most physician practices will opt for the Merit-based Incentive Payment System (MIPS) under new MACRA-mandated reimbursement strategies.

It is expected that most physician practices will opt for the Merit-based Incentive Payment System (MIPS) under new MACRA-mandated reimbursement strategies.

While digesting the implications of the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) can be an understandable distraction for physicians, the goal of the MACRA program is to return the focus to patient care, not spend time learning a new program, emphasized CMS Acting Administrator Andy Slavitt to members of the American Medical Association during the AMA's annual meeting in Chicago last week.

Early in Slavitt's comments, available in their entirety in a June 2016 post in the CMS blog, he posed the following two questions to physicians: What do you really need to know about the MACRA program? And what new sets of requirements are there to participate?

At the outset of his explanation, Slavitt emphasized Medicare will still pay for services as it always has, but every physician and other participating clinicians will have the opportunity to be paid more for better care and for making investments that support patients—like having a staff member follow up with patients at home.

As the AMA, AAFP and other physician support organizations have done, CMS will provide comprehensive MACRA documentation, Slavitt assured the association. "We will, of course, provide information in as much or as little detail as is helpful. For those who like to read computer manuals end-to-end, there is of course the 900-page proposed rule complete with every detail about how the regulation and the law is proposed to work. But, for most people, who do not need to see every scenario and how each element of the formula works, there are webinars, in-person meetings, fact sheets, and web portals that will bring all the information to suit various needs."

Slavitt then outlined three immediate features of the program designed as improvements over Medicare's existing payment system:

  • First, MACRA sunsets three disjointed programs. If you participate in the Physician Quality Reporting System, the Value Modifier, and the Meaningful Use program, your life just got simpler, as they are replaced with a single, aligned Quality Payment Program, which will reduce reporting requirements, eliminate duplication, and reduce the number of measures. For those who participate in MACRA Alternative Payment Models, those requirements are reduced further or eliminated.
  • Second, it also reduces the combined possible downward adjustment of 9 percent that is occurring today from the three programs to a maximum of 4 percent in the first year of the Quality Payment Program. The program is designed to build up over the course of several years, with more modest financial impacts in the first year when the vast majority of physicians are expected to be in the MIPS part of the program.
  • Third, while the Merit-Based Incentive portion of the law is designed to be budget neutral in general, there are new opportunities for additional bonuses. In MIPS, in addition to the 4 percent positive payment adjustment, there is the potential for much higher payments through $500 million in funding over six years. Physicians earn a 5 percent lump sum bonus for participating in an Advanced Alternative Payment Model.

Under the current proposed timing, the first physician reporting isn’t due until early 2018 for the first performance period in 2017, Slavitt said. Off-the-shelf tools like Certified EHRs and clinical data registries can provide complete capabilities, but other options exist as well, including most types of reporting that a physician is doing today.

If CMS can get data automatically or through another source, it will do so, he stated, before moving on to MACRA implementation and priorities.

Editor's Note: To briefly outline MACRA and advise on physician practice focus for the remainder of 2016 to avoid reimbursement penalties in 2017 based on the MACRA proposed rule, the Healthcare Intelligence Network will hold a 45-minute webinar on July 14, 2016: The New Physician Quality Reporting: Positioning Your Practice for MACRA's Merit-Based Incentive Payment System.

Infographic: Provider Risk Readiness

June 8th, 2016 by Melanie Matthews

The Medicare Access and CHIP Reauthorization Act (MACRA) dramatically changes Medicare physician reimbursement.

A new infographic by AMGA examines the MACRA timetable, groups affected, tools that physician groups will need for effective implementation and the biggest impediment to physician groups taking on downside risk.

With the nation's leading accountable care organizations already testing the waters with CMS' newest value-based reimbursement opportunity, the Next Generation Accountable Care Organization Model, healthcare organizations are evaluating how this new opportunity aligns with their value-based contracting strategy.

During Next Generation ACO: An Organizational Readiness Assessment, a 60-minute webinar on April 5, 2016, now available for replay, Healthcare Strategy Group's Travis Ansel, senior manager of strategic services, and Walter Hankwitz, senior accountable care advisor, will provide a value-based, risk contract roadmap to determine organizational readiness for participation in the Next Generation ACO Model in particular and in risk-based contracts in general.

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