4 Ways CMS 2018 Quality Payment Program Supports ‘Patients Over Paperwork’ Pledge

November 6th, 2017 by Patricia Donovan

“Patients Over Paperwork” is committed to removing regulatory obstacles that get in the way of providers spending time with patients.

Year 2 of the CMS Quality Payment Program promises continued flexibility and reduced provider burden, according to the program’s final rule with comment issued by the Centers for Medicare and Medicaid Services (CMS) last week.

The Quality Payment Program (QPP), established by the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA), is a quality payment incentive program for physicians and other eligible clinicians that rewards value and outcomes in one of two ways: through the Merit-based Incentive Payment System (MIPS) and Advanced Alternative Payment Models (APMs).

A QPP Year 2 fact sheet issued by CMS highlights 2018 changes for providers under the QPP’s MIPS and APM tracks. The Year 2 fact sheet noted that stakeholder feedback helped to shape policies for QPP Year 2, and that  “CMS is continuing many of its transition year policies while introducing modest changes.”

In keeping with the federal payor’s recently launched “Patients Over Paperwork” initiative, QPP Year 2 reflects the following changes:

    • More options for small practices (groups of 15 or fewer clinicians). Options include exclusions for individual MIPS-eligible clinicians or groups with less than or equal to $90,000 in Part B allowed charges or less than or equal to 200 Part B beneficiaries, opportunities to earn additional points, and the choice to form or join a virtual group.
    • Addresses extreme and uncontrollable circumstances, such as hurricanes and other natural disasters, for both the 2017 transition year and the 2018 MIPS performance period, by offering hardship exception applications and limited exemptions.
    • Includes virtual groups as another participation option for Year 2. A virtual group is a combination of two more taxpayer identification numbers (TINs) made up of solo practitioners and groups of 10 or fewer eligible clinicians who come together ‘virtually’ (no matter specialty or location) to participate in MIPS for a performance period of a year. A CMS Virtual Groups Toolkit provides more information, including the election process to become a virtual group.
    • Makes it easier for clinicians to qualify for incentive payments by participating in Advanced APMs that begin or end in the middle of a year. Updated QPP policies for 2018 further encourage and reward participation in APMs in Medicare.
  • CMS describes its Patients Over Paperwork effort as “a cross-cutting, collaborative process that evaluates and streamlines regulations with a goal to reduce unnecessary burden, increase efficiencies and improve the beneficiary experience. This effort emphasizes a commitment to removing regulatory obstacles that get in the way of providers spending time with patients.”

    Infographic: Healthcare Payment Model Reform

    November 3rd, 2017 by Melanie Matthews

    As the 79 million baby boomers turn 65, they will grow the
    Medicare-eligible cohort from 13.1 percent to 20.3 percent in 2030, according to a new infographic by HORNE Healthcare.

    The infographic provides advice for providers to prepare for success in the ever-changing healthcare reimbursement environment.

    Under CMS’s “Pick Your Pace” choices for Year 1 Quality Payment Program participation, physician practices may opt for the minimum activity necessary to avoid a payment penalty in 2019 by simply submitting some data in 2017.

    However, instead of delaying MACRA participation to the later part of this year, physicians should prepare and better position themselves today for MIPS success by analyzing their existing CMS data on their practices’ performance and laying a path now toward performance improvement.

    Physician MACRA-Readiness: Mining QRUR and Other CMS Data to Maximize MIPS Performance describes the wealth of data analytics available from the CMS Enterprise Portal–Quality Resource Use Reports (QRURs) and other reports providing a window into practice performance under the Merit-Based Incentive Payment System (MIPS). MIPS is one of two MACRA reimbursement paths and the one where most physician practices are expected to align.

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    Healthcare Hotwire: Care Coordination

    November 2nd, 2017 by Melanie Matthews

    Care coordination organizes patient care activities and information for safer and more effective care.

    Care coordination involves deliberately organizing patient care activities and sharing information among all vested participants to achieve safer and more effective care, per the Agency for Healthcare Research and Quality (AHRQ).

    These patient care activities span all care settings, including the patient’s home, according to the Healthcare Intelligence Network’s Benchmark Survey on Care Coordination.

    Initiatives aimed at coordinating care for high-risk patients are reporting healthcare cost savings, reductions in expensive sites of care and improvements in quality, outcomes and patient satisfaction.

    In the new edition of Healthcare Hotwire, you’ll get details on enhanced care coordination Medicare savings, reducing emergency department utilization through care coordination and the impact of care coordination efforts on patient and provider satisfaction.

    HIN’s newly launched Healthcare Hotwire tracks trending topics in the industry for strategic planning. Subscribe today.

    Infographic: Healthcare Consumer Loyalty Trends

    November 1st, 2017 by Melanie Matthews

    Almost half (40.37 percent) of consumers are not loyal to a hospital or health system, according to a new infographic by NRC Health.

    The infographic examines healthcare consumer loyalty drivers, the top reasons consumers switch doctors and hospitals, digital consumer health trends and the hospital and physician website information ranked as most useful to consumers.

    UnityPoint Health has moved from a siloed approach to improving the patient experience at each of its locations to a system-wide approach that encompasses a consistent, baseline experience while still allowing for each institution to address its specific needs.

    Armed with data from its Press Ganey and CAHPS® Hospital Survey scores, UnityPoint’s patient experience team developed a front-line staff-driven improvement action plan.

    Improving the Patient Experience: Engaging Front-line Staff for a System-Wide Action Plan, a 45-minute webinar on July 27th, now available for replay, Paige Moore, director, patient experience at UnityPoint Health—Des Moines, shares how the organization switched from a top-down, leadership-driven patient experience improvement approach to one that engages front-line staff to own the process.

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    HINfographic: Patient Engagement: Educate to Overcome Social Determinants of Health and Low Health Literacy

    October 30th, 2017 by Melanie Matthews

    Social determinants of health (SDOH), conditions in which individuals are born, grow, live, work and age, and low health literacy pose the greatest barriers to engaging patients in self-care, say respondents to the 2017 Patient Engagement Survey by the Healthcare Intelligence Network.

    A new infographic by HIN examines the top components of patient engagement programs, the most challenging patients to engage and the return on investment from patient engagement programs.

    Beyond hoped-for improvements in clinical outcomes from actively engaged patients, patient engagement metrics now factor heavily into the equations of risk- and value-based reimbursement models.

    2017 Healthcare Benchmarks: Patient Engagement documents tactics, targeted populations and clinical conditions, program components, technology use, success measures, challenges and many other patient engagement metrics reported by 75 healthcare organizations responding to the 2017 Patient Engagement survey by the Healthcare Intelligence Network.

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    Infographic: What Consumers Say About Digital Health

    October 27th, 2017 by Melanie Matthews

    Digital technologies are successfully revolutionizing the core functionalities of several industries, including the healthcare industry. From increasing patient engagement and staff productivity to bridging the provider-patient gap to facilitating better storage capabilities, digital health solutions provide endless opportunities for healthcare organizations to improve efficiency, according to a new infographic by TechJini.

    The infographic demonstrates how consumers are responding to digital health.

    2016 Healthcare Benchmarks: Digital HealthDigital health, also referred to as ‘connected health,’ leverages technology to help identify, track and manage health problems and challenges faced by patients. Person-centric health management is slowly acknowledging the device-driven lives of patients and health plan members and incorporating these tools into care delivery and management efforts.

    2016 Healthcare Benchmarks: Digital Health examines program goals, platforms, components, development strategies, target populations and health conditions, patient engagement metrics, results and challenges reported by more than 100 healthcare organizations responding to the February 2016 Digital Health survey by the Healthcare Intelligence Network.

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    Infographic: Reducing Healthcare Supply Chain Expenses

    October 25th, 2017 by Melanie Matthews

    The pressure on hospitals and health systems to simultaneously improve quality and reduce costs will only intensify, no matter the outcome of healthcare reform, according to a new infographic by Navigant.

    The infographic examines the substantial savings opportunities within the healthcare supply chain.

    Healthcare Trends & Forecasts in 2017: Performance Expectations for the Healthcare Industry Not in recent history has the outcome of a U.S. presidential election portended so much for the healthcare industry. Will the Trump administration repeal or replace the Affordable Care Act (ACA)? What will be the fate of MACRA? Will Medicare and Medicaid survive?

    These and other uncertainties compound an already daunting landscape that is steering healthcare organizations toward value-based care and alternative payment models and challenging them to up their quality game.

    Healthcare Trends & Forecasts in 2017: Performance Expectations for the Healthcare Industry, HIN’s 13th annual business forecast, is designed to support healthcare C-suite planning during this historic transition as leaders prepare for both a new year and new presidential leadership.

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    Healthcare Hotwire: Social Determinants of Health

    October 25th, 2017 by Melanie Matthews

    Healthcare risk sharing requires a new focus on the whole patient…addressing all of the factors that could impact the health of accountable populations.

    Evidence is mounting that social determinants of health—social, economic and environmental factors that impact quality of life—significantly influence population health.

    Initiatives such as CMS’ Accountable Health Communities Model and other population health platforms encourage healthcare organizations to tackle the broad range of social, economic and environmental factors that shape an individual’s health. Mission Health recently attributed its success in CMS’ Medicare Shared Savings Program to its care coordination model that addresses the whole person.

    And 2015 research by Brigham Young University found that the social determinants of loneliness and social isolation are just as much a threat to longevity as obesity.

    In the new edition of Healthcare Hotwire, you’ll get details on how social health determinants impact patient populations and what healthcare organizations are doing to address these factors.

    HIN’s newly launched Healthcare Hotwire tracks trending topics in the industry for strategic planning. Subscribe today.

    Infographic: Healthcare Payments Myths

    October 23rd, 2017 by Melanie Matthews

    There are a lot of myths circulating in the healthcare industry about patients’ payment preferences, according to a new infographic by InstaMed.

    The infographic examines these myths and provides more detail on how patients want to pay.

    Healthcare Trends & Forecasts in 2017: Performance Expectations for the Healthcare Industry Not in recent history has the outcome of a U.S. presidential election portended so much for the healthcare industry. Will the Trump administration repeal or replace the Affordable Care Act (ACA)? What will be the fate of MACRA? Will Medicare and Medicaid survive?

    These and other uncertainties compound an already daunting landscape that is steering healthcare organizations toward value-based care and alternative payment models and challenging them to up their quality game.

    Healthcare Trends & Forecasts in 2017: Performance Expectations for the Healthcare Industry, HIN’s 13th annual business forecast, is designed to support healthcare C-suite planning during this historic transition as leaders prepare for both a new year and new presidential leadership.

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    Infographic: Digital Connectedness & Consumer Healthcare

    October 20th, 2017 by Melanie Matthews

    As healthcare brands continue to grow and evolve, they must increase their digital presence in a strategic, digitally savvy manner, according to a new infographic by Paragon Solutions, Inc.

    The infographic examines the consumer digital experience and provides three key digital health strategies.

    2016 Healthcare Benchmarks: Digital HealthDigital health, also referred to as ‘connected health,’ leverages technology to help identify, track and manage health problems and challenges faced by patients. Person-centric health management is slowly acknowledging the device-driven lives of patients and health plan members and incorporating these tools into care delivery and management efforts.

    2016 Healthcare Benchmarks: Digital Health examines program goals, platforms, components, development strategies, target populations and health conditions, patient engagement metrics, results and challenges reported by more than 100 healthcare organizations responding to the February 2016 Digital Health survey by the Healthcare Intelligence Network.

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