Posts Tagged ‘physician reimbursement’

Infographic: Preparing for MACRA

April 21st, 2017 by Melanie Matthews

Only 35 percent of health systems have a MACRA strategy and are going to be ready to participate, according to a new infographic by Health Catalyst.

The infographic examines the top MACRA concern, preparation levels and potential benefits.

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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Infographic: MACRA Pathways

November 16th, 2016 by Melanie Matthews

Under MACRA, 2017 will be the first performance year physicians will be scored to determine payment adjustments in 2019. Physicians will choose between two payment tracks: the Merit-based Incentive Payment System (MIPS) or the Alternative Payment Model (APM), according to a new infographic by the American Academy of Family Physicians (AAFP).

The infographic highlights the path options physicians can choose.

Infographic: MACRA Pathways

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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Infographic: 10 Things To Know About MACRA

October 3rd, 2016 by Melanie Matthews

The Medicare Access and CHIP Reauthorization Act provides a new framework for the drive toward value-based reimbursement for physicians, according to a new infographic by athenahealth Inc.

The infographic provides physicians with 10 critical steps to prepare for MACRA.

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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Infographic: Are You Ready to Add Recurring Revenue to Your Physician Practice?

July 20th, 2016 by Melanie Matthews

Some 68 percent of the Medicare population have two or more chronic conditions, according to a new infographic by CareSync.

The infographic examines how physician practices can bill for chronic care management (CCM) services under CMS’ CCM program and the impact of CCM on outcomes and the patient experience.

Chronic Care Management Reimbursement Compliance: Physician Requirements for Value-Based RevenueBeyond providing added revenue, billing via Medicare Chronic Care Management (CCM) CPT codes helps to bridge physician practices to value-based care delivery models like the accountable care organization (ACO) or patient-centered medical home (PCMH). Use of the CCM codes is also an opportunity to launch or enhance a chronic care management program. According to 2015 market data, nearly half of responding healthcare organizations lack a formal chronic care management structure, leaving critical reimbursement dollars on the table.

However, practices poised to bill under CCM codes must contend with vague guidance from CMS in certain areas and conflicting interpretations from outside sources on CCM implementation.

Chronic Care Management Reimbursement Compliance: Physician Requirements for Value-Based Revenue sets the record straight on CCM reimbursement compliance, offering strategies for navigating obstacles and meeting requirements.

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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: 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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Infographic: Chronic Care Management Revenue Opportunities

December 9th, 2015 by Melanie Matthews

The value of gaining experience and proficiency with population management and value-based reimbursement is becoming essential as Medicare shifts a greater portion of its payments to these methodologies. Medicare’s chronic care management reimbursement codes allow practices to get paid while learning about this new shift and gaining confidence and competence with value-based reimbursement, according to a new infographic by McKesson.

The infographic examines the incidence of chronic conditions among Medicare beneficiaries and the revenue opportunity for practices that bill Medicare under the Chronic Care Management codes.

Starting this past January, Medicare is reimbursing physician practices for select Chronic Care Management (CCM) services not previously eligible for reimbursement, underscoring the vital role of care management in primary care.

Physician Reimbursement for Chronic Care Management: Identifying New Practice Revenue Opportunities offers practical guidance to prepare physician practices to maximize CCM reimbursement in the year ahead.

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How Aligned Incentives and Evidence-Based Care Support Patient Engagement

December 8th, 2015 by Patricia Donovan

Best practice care standards and new models of provider compensation round out Intermountain Healthcare's patient engagement framework.

Intermountain Healthcare’s vision of shared accountability among patients, payors, providers and even the community is constructed around three key tenets: engaging patients, delivering evidence-based care and aligning provider assignments. Here, Tammy Richards, corporate director of patient and clinical engagement at Intermountain Healthcare, expands upon the latter two pillars, and how they support her organization’s six-stage patient engagement framework.

Regarding evidence-based care, Intermountain has demonstrated that higher quality often costs less. Patients typically have better health medical outcomes and tend to experience fewer complications and readmissions, and through our extensive data repositories, Intermountain’s clinical programs and services are ramping up developments and consistent use of those best practice standards. Our term for that is “care process models.”

Patient engagement means that patients are in involved in their own health and care choices and they interact meaningfully with caregivers. That’s the key. What does “meaningfully” mean and can it be accomplished through technology? Does it require face to face interactions? What portion of each will make the difference there? We engage patients in wellness and prevention decisions, choices about their care or develop models of care to support patients in their unique circumstances. Population health is most definitely the focus.

We are also looking at electronic tools. We’re aggressively pursuing transparency specifically and publicly reporting star ratings for individual providers and physicians, as well as those comments submitted by patients about those physicians. We’re also addressing the emotional labor of medicine and decision fatigue. By aligning financial incentives, we create a payment system that rewards hospitals and physicians for providing the right care rather than just more care.

Intermountain supports the Institute of Medicine recommendation to address these three types of substandard care: under-treatment, or doing too little; overtreatment, doing too much; and clinical mistakes. All three types of substandard care pose medical risks to patients, and we are addressing decision fatigue with that in mind.

We’re developing new models for compensating hospitals and physicians. These models are based on a combination of productivity, quality, service and total cost of care. In addition to that, SelectHealth, our insurance company, is designing health plan benefits that encourage members to participate in their care and to consider financial impacts of their healthcare decisions. Of course, we also focus traditionally on efficiency, which helps us manage costs.

We know regardless of our circumstances or histories, we also must now acknowledge that assuming full financial risk for patient populations and increasing pressures or reduced cost in healthcare means placing more emphasis on improving patient outcomes.

Source: Framework for Patient Engagement: 6 Stages to Success in a Value-Based Health System

http://hin.3dcartstores.com/Framework-for-Patient-Engagement-6-Stages-to-Success-in-a-Value-Based-Health-System_p_5102.html

Framework for Patient Engagement: 6 Stages to Success in a Value-Based Health System details Intermountain Healthcare’s multilayered approach and how it supports its corporate mission: Helping people live the healthiest lives possible.

Infographic: Chronic Care Management Reimbursement Trends

October 23rd, 2015 by Melanie Matthews

Chronic Care Management Reimbursement TrendsPhysician participation in the chronic care management program is expected to grow to 70 percent of all practices by the third quarter of 2016, according to a new infographic by Smartlink Mobile.

The infographic looks at the program’s impact on physician practices and practices’ understanding of the program requirements.

Starting this past January, Medicare is reimbursing physician practices for select Chronic Care Management (CCM) services not previously eligible for reimbursement, underscoring the vital role of care management in primary care.

Physician Reimbursement for Chronic Care Management: Identifying New Practice Revenue Opportunities offers practical guidance for physician practices to maximize CCM reimbursement.

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Infographic: 4 Key Steps to Increasing Physician Practice Revenue

September 25th, 2015 by Melanie Matthews

There are several key steps physician practices can take to help grow their practice revenue, according to a new infographic by MedLanding News.

4 Key Steps to Increasing Physician Practice Revenue

Lessons from a Leading Pioneer ACO: Value-Based Gains from Physician Engagement, Performance Improvement and Care ManagementFollowing Pioneer ACO Year 3 results released by CMS in August 2015, Steward Health Care Network continues to make good on its Promise to provide coordinated, high-quality and cost-efficient care to its 80,000 Pioneer-aligned Medicare beneficiaries. Promise, Steward’s top-performing Pioneer ACO, has generated $30 million of savings in its first three years of participation, according to recently published data.

Lessons from a Leading Pioneer ACO: Value-Based Gains from Physician Engagement, Performance Improvement and Care Management provides veteran advice from Kelly Clements, Pioneer Program Director, Steward Health Care Network. Steward is one of 20 accountable care organizations remaining in the Pioneer program and one of 15 reporting savings for year 3 (2014).

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