Rewarding Provider Performance: Ten Years In
Editor’s note: When we read Sharon Long and colleagues’ retrospective on Massachusetts health reform at 10 years in the September issue of Health Affairs we were reminded just what a busy year 2006 was for health policy writ large (in addition to wondering ‘Has it been that long already?’). Now a decade later, we think there’s something to be gained from looking back on the impact and reach of some of the most significant policies implemented that year. With that in mind, Health Affairs Blog invited a handful of policy makers and researchers to reflect on some of these major milestones, share lessons learned, and...
Source: Health Affairs Blog - December 6, 2016 Category: Health Management Authors: Gail R. Wilensky Tags: Costs and Spending Featured Health Professionals Medicare Payment Policy Quality 2006 Alternative Payment Models MACRA Physician Quality Reporting System Physicians value-based payment Source Type: blogs
Part Two: MACRA More MIPS, and APMs
In part two of our MACRA analysis, we continue our look at MIPS and evaluate the APM pathway of MACRA’s new quality payment program.
Small Practice Considerations
Exemption
Key finalized policies include a small practice-friendly low volume threshold. In 2017, the threshold has been set at “less than or equal to $30,000 in Medicare Part B allowed charges or less than or equal to 100 Medicare patients.” CMS says this new threshold represents 32.5 percent of Medicare clinicians but only 5 percent Medicare Part B spending.
CMS says that the new flexibilities from the final rule lessen the impact on smal...
Source: Policy and Medicine - December 4, 2016 Category: American Health Authors: Thomas Sullivan - Policy & Medicine Writing Staff Source Type: blogs
Calculating Medicare Advantage/Fee-For-Service Price Differences Is Harder Than It Looks
Understanding whether fee-for-service (FFS) Medicare and Medicare Advantage (MA) plans pay different prices is important — but more difficult to determine than it seems. In “Medicare Advantage Plans Pay Hospitals Less Than Traditional Medicare Pays,” we reported that MA plans paid hospitals 8 percent less, on average, than did FFS for a standard basket of hospital services. Our colleagues at the Medicare Payment Advisory Commission (MedPAC) have since alerted us that we did not account for differences in the way that hospitals receive Indirect Medical Education (IME) payments for MA, as compared to FFS, beneficia...
Source: Health Affairs Blog - November 28, 2016 Category: Health Management Authors: Laurence Baker, M. Kate Bundorf, Aileen Devlin and Daniel Kessler Tags: Costs and Spending Featured Medicare Payment Policy fee-for-service Medicare Advantage Source Type: blogs
Part One: MACRA Overview and MIPS
In its final MACRA rule, CMS significantly revamped the physician pay rule to make it easy for physicians to avoid penalties and to earn bonuses, and the agency is leaving the final rule open for comment to make it easier to revise. Among the changes, physicians need only report on one quality measure in each of two categories next year to avoid penalties, a third of practices are exempted from the program entirely, and there is a new alternative pay model option aimed at making it easier for small practices to qualify for the 5 percent bonus that comes with being counted as an alternative pay model.
MACRA: An Overview
T...
Source: Policy and Medicine - November 27, 2016 Category: American Health Authors: Thomas Sullivan - Policy & Medicine Writing Staff Source Type: blogs
Round Up No Suspects: the Bio Telemetry Settlement Demonstrates the Continuing Impunity of Health Care Organizational (and Other) Leaders
Themarch of legal settlements by important health care organizations continues, although now producing barely an additional ripple on top of the white-capped covered ocean of news and commentary roiled by the recent US election. However, even the latest small settlement is a reminder of all the problems that continue under the surface. (And I have now beaten this metaphor to death, sorry.)The SettlementAs reported very brieflyin NJ.com:A company that monitors cardiac devices worn by heart patients has agreed topay $1.3 million in civil fines to resolve allegations it paid kickbacks to doctors to persuade them t...
Source: Health Care Renewal - November 22, 2016 Category: Health Management Tags: bribery health care corruption impunity kickbacks legal settlements medical devices Source Type: blogs
Building Better Metrics: Patient-Driven Metrics
By NIR AL AGBA, MD
Recently I wrote about empowerment and the importance of letting patients make their own health care decisions. Our job is to make sure patients are given information and then allowed to choose the best option for them. Maybe we should even embolden patients; give them confidence and encourage them to take more control. Physicians tend to feel more comfortable advising according to the “standard of care” and we struggle handing over the reins when we believe we “know” the safest path to take.
Every time I talk about building better metrics, I emphasize the significance of evaluating something...
Source: The Health Care Blog - October 5, 2016 Category: Consumer Health News Authors: John Irvine Tags: Uncategorized Metrics Nir Al-Agba Patient Satisfaction Source Type: blogs
I am a Terrible Doctor; and I ’ m Proud of it
It’s that time again. As the year draws to a close, various insurance plans try to finish collecting data to calculate bonus payments as “incentives” for “Quality” care. The only problem is that, as I’ve written before, all of their “Quality” measures are in fact nothing but proxies for cost, most of which I have no control over.
Back in the 1990s at the beginning of the Managed Care era, the model of the primary physician was that of gatekeeper. Twenty years later, the last vestiges of this model is the wretched “Referral,” a word which used to mean something but...
Source: Musings of a Dinosaur - October 4, 2016 Category: Primary Care Authors: notdeaddinosaur Tags: Medical Source Type: blogs
More Regulation Won't Make Housing Affordable
A newHousing Policy Toolkit from the White House admits that “local barriers to housing development have intensified,” which “has reduced the ability of many housing markets to respond to growing demand.” The toolkit, however, advocates tearing down only some of the barriers, and not necessarily the ones that will work to make housing more affordable.“Sunbelt cities with more permeable boundaries have enjoyed outsized growth by allowing sprawl to meet their need for adequate housing supply,” says the toolkit. “Space constrained cities can achieve similar gains, however, by building up with infill.” Yet this...
Source: Cato-at-liberty - September 29, 2016 Category: American Health Authors: Randal O'Toole Source Type: blogs
Reducing Low-Value Care
The use of low-value care is more than just a small problem in the United States, the Institute of Medicine indicated an estimate of $765 billion wasted health care expenditures in 2013 (Figure 1). Solutions to measure, identify, and eliminate low-value care, however, are challenging and complex. To date, most efforts aimed at reducing low-value care, such as the Choosing Wisely Initiative, have been limited to areas where there is high degree of consensus that the care rendered is low value.
In order to get a better understanding of the complexities of low-value care, we conducted interviews with 13 people representing a ...
Source: Health Affairs Blog - September 20, 2016 Category: Health Management Authors: Beth Beaudin-Seiler, Michael Ciarametaro, Robert Dubois, Jim Lee and A. Mark Fendrick Tags: Equity and Disparities Featured Quality Choosing Wisely low-value care Source Type: blogs
The Two Strategies That Skyrocketed My Motivation by 49.08%
You're reading The Two Strategies That Skyrocketed My Motivation by 49.08%, originally posted on Pick the Brain | Motivation and Self Improvement. If you're enjoying this, please visit our site for more inspirational articles.
Is a lack of motivation crippling you?
It’s not your fault.
Research has proven two strategies that skyrocket motivation, but we don’t teach them in schools or the workplace.
As a culture, we have given up on the science of motivation. Instead, we share inspirational cat pictures on Facebook. While I have nothing against inspirational pictures (or cats), that’s just not effective instruction....
Source: PickTheBrain | Motivation and Self Improvement - September 19, 2016 Category: Consumer Health News Authors: Stephen Roe Tags: featured happiness motivation self improvement best motivation blogs how to stay motivated pickthebrain success Source Type: blogs
Most Hospitals Offer Patients Electronic Access to Medical Records
This post was originally published on http://www.healthpopuli.com/ on September 14, 2016.
The number of hospitals offering patients electronic access to their health information grew seven times between 2013 and 2015. Electronic health records access has gone mainstream in America, according to the latest findings by The Office of the National Coordinator for Health Information Technology (ONC-HIT).
The data are detailed in Electronic Capabilities for Patient Engagement among U.S. Non-Federal Acute Care Hospitals: 2012-2015, an ONC Data Brief.
Two in three U.S. patients can now view, download, and transmit their personal...
Source: Disruptive Women in Health Care - September 15, 2016 Category: Consumer Health News Authors: dw at disruptivewomen.net Tags: Electronic Health Records Health IT Source Type: blogs
CMS Delay ’s Full MACRA Implementation to the Next Administration
In a blog post, CMS announced changes to the Medicare Access & CHIP Reauthorization Act of 2015 (MACRA) that will allow physician practices to choose the level and pace at which they comply with the new payment reform model aimed at emphasizing quality patient care over volume. The announcement comes after pressure from industry stakeholders and policymakers to ease implementation of MACRA, which is set to start January 1, 2017. We previously reported that CMS was considering a potential MACRA delay, and this appears to be what the agency will finalize in its November rule.
The Announcement
Acting CMS Administrator...
Source: Policy and Medicine - September 11, 2016 Category: American Health Authors: Thomas Sullivan - Policy & Medicine Writing Staff Source Type: blogs
Medicare Accountable Care Organization Results For 2015: The Journey To Better Quality And Lower Costs Continues
We examined this effect further in a preliminary regression model adjusting for benchmark and population size and found that a significant regional effect persisted. Further analysis is needed to understand the causes of this “Southern effect.” The map in Exhibit 10 shows how the savings rate varies by state.
Exhibit 9. Rates of shared savings in different regions in the country
The South has higher shared savings rates than other geographic regions.
Exhibit 10. Map illustrating the average savings for ACOs in different states
Total Impact
In 2015, beneficiaries in the MSSP cost CMS $72.9 billion dollars against an e...
Source: Health Affairs Blog - September 9, 2016 Category: Health Management Authors: David Muhlestein, Robert Saunders and Mark McClellan Tags: Following the ACA Medicare Organization and Delivery Payment Policy Quality Accountable Care Organizations ACOs MSSP shared savings Source Type: blogs
Oh So Quietly, Evidence of Bad Health Care Corporate Leadership Accumulates - Three AstraZeneca Settlements
While the news media is distracted by seemingly more spectacular issues, we hear the steady drip, drip, drip oflegal cases suggesting just how systemically bad the leadership of big health care organizations is. From February 2015 to now, for example, there have been three cases involving multinational pharmaceutical giant AstraZeneca.Settlement of Allegations of Kickbacks to Give AZ Drugs Preferred Status in FormulariesFirst, in February 2015, reported in most detail by Ed Silvermanin the Wall Street Journal,AstraZeneca has agreed to pay the federal government $7.9 million to settle allegations the drug maker paid k...
Source: Health Care Renewal - September 8, 2016 Category: Health Management Tags: AstraZeneca bribery deception impunity kickbacks legal settlements Source Type: blogs
Anatomy of a Brutal Tax Beating
Based on the title of this column, you may think I ’m going to write aboutoppressive IRS behavior orpunitive tax policy.Those are good guesses, but today ’s “brutal tax beating” is about what happens when a left-leaning journalist writes a sophomoric column about tax policy and then gets corrected by an expert from the Tax Foundation.The topic is the tax treatment of executive compensation, which is somewhat of a mess because part ofBill Clinton ’s 1993 tax hike was a provision to bar companies from deducting executive compensation above $1 million when compiling their tax returns (which meant, for all intents an...
Source: Cato-at-liberty - September 8, 2016 Category: American Health Authors: Daniel J. Mitchell Source Type: blogs
