Archive for the ‘Physician Practices’ Category

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."

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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Infographic: The Power of the First Call in the Patient Experience

June 1st, 2016 by Melanie Matthews

There are several distinct elements of a phone call that will determine a patient's experience, according to the Baird Group, which conducts mystery-shopping assessments via the phone. The Baird Group has collected data from thousands of mystery shopping phone calls to healthcare organizations throughout the country, and found the good, the bad and the downright ugly.

The Baird Group created an infographic that gives a visual summary of the findings—one of the most startling findings is that 35 percent of first time callers are not likely to return.

Transformational patient-centered models emerging post-ACA are designed to succeed with a core of engaged, activated patients, yet enlistment of individuals in chronic care management, telehealth and other health enhancement interventions continues to challenge the healthcare industry.

2015 Healthcare Benchmarks: Patient Engagement documents strategies, program components, successes and challenges of engaging patients and health plan members in self-care from 133 organizations responding to the 2015 Patient Engagement survey by the Healthcare Intelligence Network.

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Infographic: MACRA Countdown to Measurement Year Goals

May 27th, 2016 by Melanie Matthews

Under MACRA, the physician quality measurement systems in place in 2017 will determine physician Medicare reimbursement in 2019, according to a new infographic by Geneia.

The infographic describes the pace of change in physician value-based reimbursement, the adjustments that will be made to Medicare claims starting in 2019 and three steps that practices should be taking now to be ready.

Since the January 2015 rollout by CMS of new chronic care management (CCM) codes, many physician practices have been slow to engage in CCM. Arcturus Healthcare, however, rapidly grasped the potential of CCM to improve patient outcomes while generating care coordination revenue, estimating it could earn up to $100,000 monthly for qualified patients treated in its four physician practices—or $1 million a year.

Medicare Chronic Care Management Billing: Evidence-Based Workflows to Maximize CCM Revenue traces the incorporation of CCM into Arcturus Healthcare's existing care management efforts for high-risk patients, as well as the bonus that resulted from CCM code adoption: increased engagement and improved relationships with CCM patients.

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Are You MACRA-Ready? Physician Groups Prep Members for Medicare Payment Modernization

May 16th, 2016 by Patricia Donovan

Physician groups digested the 962-page MACRA notice of proposed rule-making in order to distill the notice for their members.

As they digest the HHS's momentous proposal to modernize how Medicare provider payments are tied to the cost and quality of patient care, physician organizations are assembling arsenals of educational tools to de-mystify MACRA.

The federal government's first step in implementing certain provisions of the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) was detailed in an April 2016 announcement.

Just nine days after that bulletin, the AAFP arranged a town hall meeting for its members with two high-ranking CMS officials to discuss the law that will greatly influence how physicians are paid. Comments provided by CMS Acting Administrator Andy Slavitt via conference call are detailed here.

While the HHS window to receive feedback on the proposal remains open through June 27, 2016, the AMA has created an extensive set of online resources to support physician preparations for a post-MACRA Medicare. The resources include a guide to physician-focused payment models, key points of the Merit-based Incentive Payment System (MIPS), and five things providers can do now to prepare for the legislation, among other resources, according to a May 2016 press release.

“The core policy elements in MACRA are surfacing in other public and private insurance programs, so understanding these policies will be essential for most physician practices,” said AMA President Steven J. Stack, MD.

The AMA's MACRA support tools were announced in conjunction with the release of its new interactive module on practicing value-based care authored by Grace Terrell, MD, an internal medicine physician and president of Cornerstone Health Care, who shares the proven steps her clinic used to focus on patients at the center of care.

The value-based care module is the latest in the AMA’s STEPS Forward™ collection of physician-developed practice improvement strategies.

Also readying its membership for MACRA is the AAFP, which last week launched a comprehensive member communication and education effort related to the proposed legislation. The AAFP's MACRA Ready site is a one-stop shop filled with resources family physicians can use right now such as the following:

  • A timeline of important MACRA dates;
  • A list of acronyms to help digest the alphabet soup associated with MACRA's complicated regulations;
  • A "MACRA in a Minute" 60-second overview video;
  • A deep-dive review of what value-based payment means to family physicians;
  • and much more.

In announcing the MACRA tools, AAFP President Wanda Filer, MD, MB, told family physicians that the academy's MACRA communication plan "is designed to help simplify the transition and provide the guidance that you will need to realize the benefits of MACRA and value-based payments."

A recent AAFP survey indicated that some 40 percent of family physicians already were involved in some kind of value-based payment system, she noted.

As she related the history of MACRA, Dr. Filer reminded members that the legislation not only repealed the sustainable growth rate (SGR) but also established an annual positive or flat-fee payment for the next 10 years as well as a two-track program (the MIPS, and Alternative Payment Models, referred to as APMs) for calculating Medicare payments beginning in 2019.