CMS Releases Proposed MACRA Rule (Including CME as Improvement Activity)
On Tuesday, the Centers for Medicare & Medicaid Services (CMS) released the long-anticipated proposed rule updating the Quality Payment Program – the program implementing the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) – for 2018. The rule continues the CMS trend of allowing more and more physicians to delay MACRA implementation, as many smaller and rural providers have said their lack of capital and resources make compliance difficult.
MACRA will eliminate the sustainable growth formula and replace it with a .5% annual rate increase through 2019, when physicians are encouraged to shift to either ...
Source: Policy and Medicine - June 21, 2017 Category: American Health Authors: Thomas Sullivan - Policy & Medicine Writing Staff Source Type: blogs
CMS Releases Proposed 2018 MACRA Rule (Including QI CME as Improvement Activity)
On Tuesday, the Centers for Medicare & Medicaid Services (CMS) released the long-anticipated proposed rule updating the Quality Payment Program – the program implementing the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) – for 2018. The rule continues the CMS trend of allowing more and more physicians to delay MACRA implementation, as many smaller and rural providers have said their lack of capital and resources make compliance difficult.
MACRA will eliminate the sustainable growth formula and replace it with a .5% annual rate increase through 2019, when physicians are encouraged to shift to either ...
Source: Policy and Medicine - June 21, 2017 Category: American Health Authors: Thomas Sullivan - Policy & Medicine Writing Staff Source Type: blogs
Why Small Medical Practices Are at Great Risk for a Cyber Attack
The good people at ClinicSpectrum recently shared a look at why small practices are at risk for a cyber attack. They label it as why your EHR is at risk for a cyber attack, but I think their list is more specific to small practices as opposed to EHR. Take a look at their list:
Each of these issues should be considered by a small medical when it comes to why they are at risk for a cyber attack. However, the first one is one that I see often. Many small practices wonder, “Why would anyone want to hack my office?”
When it comes to that issue, medical practices need to understand how most hackers work. Most hacker...
Source: EMR and HIPAA - June 14, 2017 Category: Information Technology Authors: John Lynn Tags: Healthcare HealthCare IT HIPAA Breaches HIPAA General EHR Hacking EHR Security Healthcare Hackers Healthcare Security Medical Practice Security Small Medical Practices Source Type: blogs
The slow death of private practices
Doctors have been bemoaning changes in the practice of medicine for years and with good reason. It’s harder and harder to make a go of it in private practice. In recent years our area has lost several small practices — Hal Grotke’s Redwood Family Practice closed, Dr. Garcia retired, Teresa Marshall’s solo office shut its doors, Eureka Internal Medicine transitioned to Humboldt Medical Specialists (which then became St. Joseph Hospital Medical Group) and Beverly Copeland relocated to Ashland.
As I was writing this, Dr. Windham announced that he is ceasing the provision of primary care at his small office. Unfortunat...
Source: Kevin, M.D. - Medical Weblog - June 13, 2017 Category: General Medicine Authors: < a href="http://www.kevinmd.com/blog/post-author/emily-dalton" rel="tag" > Emily Dalton, MD < /a > Tags: Physician Primary care Source Type: blogs
MACRA Is Broken. It Needs to Go Away Now.
By KIP SULLIVAN
At its January 12, 2017 meeting, the Medicare Payment Advisory Commission (MedPAC) made it clear they had reached the conclusion that the Merit-based Incentive Payment System (MIPS) cannot work (see my last post ). MIPS is the larger of the two programs within MACRA; the Alternative Payment Model (APM) program is the other. The commission’s primary rationale for its conclusion about MIPS is that it’s not possible to measure physician “merit” (cost and quality) at the individual physician level.
But rather than recommend that Congress repeal MACRA (the Medicare Access and CHIP Reauthorization Act), ...
Source: The Health Care Blog - April 15, 2017 Category: Consumer Health News Authors: John Irvine Tags: Uncategorized Alternate Payment Model APM MACRA MIPS Source Type: blogs
Measuring MACRA
By STEVEN FINDLAY
With all the machinations over ACA repeal and replace, the new law that makes big changes in the way the federal government pays doctors—the Medicare Access and CHIP Reauthorization Act, or MACRA—hasn’t garnered much attention lately.
But doctors nationwide are sure thinking about it. That includes many of the regular commentators on THCB. I think it’s accurate to say that most of them have been highly critical of MACRA since the law was enacted in April 2015, and even after it was significantly amended late last year to address physician complaints. (See, for example, Kip Sullivan’s most recent...
Source: The Health Care Blog - April 15, 2017 Category: Consumer Health News Authors: John Irvine Tags: Uncategorized MACRA MIPS Steven Findlay Source Type: blogs
Calcium Scan and Subtractive Medicine
By SAURABH JHA MD
Being a radiologist, I rarely speak to patients, but I was asked to counsel Mrs. Patel (not her real name, so calm down HIPAA totalitarians), who was worried about the risks of radiation from cardiac calcium CT scan. Because of her risk factors for atherosclerosis, her cardiologist wanted her to take statins for primary prevention, but she was reluctant to start statins. They eventually reached a truce. If she had even a speck of calcium in her coronary arteries she would take statins. If her calcium score was zero she wouldn’t. This type of shared decision making is the most frequent reason why cardiol...
Source: The Health Care Blog - April 3, 2017 Category: Consumer Health News Authors: at RogueRad Tags: Patients Small Practice Source Type: blogs
Deloitte Survey on Value-Based Care
We have written for years about the transition in health care from volume-based to value-based payment models. But the process has been a slow one. According to the Deloitte 2016 Survey of US Physicians, a nationally representative sample of 600 US primary care and specialty physicians, confirms the slow pace of adoption of value-based payment models among physicians. Generally, physicians are reluctant to bear financial risk for care delivery. Yet many physicians conceptually endorse some of the principles behind value-based care, such as quality and resource utilization measurement. The survey results suggest that financ...
Source: Policy and Medicine - March 24, 2017 Category: American Health Authors: Thomas Sullivan - Policy & Medicine Writing Staff Source Type: blogs
OIG Reviews QPP
Conclusion
This report is a mixed bag for CMS and stakeholders of the new QPP. On one hand, CMS is clearly trying to avoid the same kind of problems that impacted the ACA roll out. However, with such a massive undertaking, there are many vulnerabilities and it is not clear that CMS has the track record worth believing the agency’s promises to be ready. There will likely be technical challenges associated with the QPP and that may only further the calls to reform the program, especially with friendly staffers leading HHS and CMS in the Trump Administration.
Related StoriesSenate Fin...
Source: Policy and Medicine - February 28, 2017 Category: American Health Authors: Thomas Sullivan - Policy & Medicine Writing Staff Source Type: blogs
A Reset For Physicians?
By PAUL KECKLEY
Last week, the nominee to run the Centers for Medicare and Medicaid Services, Seema Verma testified before the Senate Finance Committee. She conveyed a message akin to that of her new boss, Health and Human Services Secretary Tom Price, a physician and House of Representatives veteran: the federal government has made life miserable for providers adding unnecessary complexity and cost.
She challenged the value of electronic health records especially in small practices and rural settings and likened interoperability to a bridge too far. And she observed that Medicare and Medicaid, that cover 128 million Amer...
Source: The Health Care Blog - February 20, 2017 Category: Consumer Health News Authors: John Irvine Tags: Uncategorized Source Type: blogs
Newly Released CMS Payment Models – What is to Come?
Right before the inauguration of the new President, the Centers for Medicare & Medicaid Services (CMS) finalized new Innovation Center models. The announcement finalizes significant new policies related to: (1) cardiac care; three new payment models will support clinicians in providing care to patients who receive treatment for heart attacks, heart surgery to bypass blocked coronary arteries, or cardiac rehabilitation following a heart attack or heart surgery; (2) orthopedic care; one payment model will support clinicians in providing care to patients who receive surgery after a hip fracture, other than hip replacement...
Source: Policy and Medicine - February 19, 2017 Category: American Health Authors: Thomas Sullivan - Policy & Medicine Writing Staff Source Type: blogs
Headlines We Won ’ t See In 2017
By BILL REID
Earlier, I offered a sarcastic headline view of the coming year. Yet, underlying these headlines are some more serious issues that we as an industry have to address. They may not happen this year, but we need to continue to make progress. Wouldn’t it be awesome if for once we under predicted what will happen?
Healthcare Organization Wakes Up In Strange Place, Reports Massive Headache
Reality: Many organizations are not quite sure what hit them – they have purchased and implemented a number of systems, sometime more than once, in the last several years and now are waking up to the reality that that ...
Source: The Health Care Blog - February 2, 2017 Category: Consumer Health News Authors: Matthew Holt Tags: THCB Bill Reid Predictions 2017 Source Type: blogs
Building The Value-Based Health Care System Of The Future Depends On Meeting Clinicians ’ Data Needs
Data is the lifeblood of the value-based payment environment. Every time a doctor takes care of a patient, we have an opportunity to use information in ways that help patients get better care. The goal is to use the information from each patient encounter to make the next encounter better — across the entire health care system. But it is easier said than done. As we prepare to transition from this administration, we’d like to take stock of what our nation has accomplished and to lay out a potential roadmap for the next administration.
Making data easy to use begins by putting it into secure, private, digital form. ...
Source: Health Affairs Blog - January 17, 2017 Category: Health Management Authors: Vindell Washington and Andy Slavitt Tags: Featured Health IT big data EHRs ONC value based care Source Type: blogs
One year later: A physician ’s letter to Medicare patients
Dear patients,
One year ago, I wrote to you about my concerns for the future of my practice in light of upcoming changes to the Medicare system. I explained my anxiety about the Medicare Access and CHIPS Reauthorization Act (MACRA), a change in fee structure from fee-for-service (I treat you in the office, submit the bill to Medicare, and they pay the bill), to “value-based” payment (I treat you in the office, submit the bill to Medicare, and they decide if my care provided adequate value to warrant payment).
This payment change guarantees to financially penalize 50 percent of Medicare providers, mostly solo and smal...
Source: Kevin, M.D. - Medical Weblog - December 29, 2016 Category: Journals (General) Authors: < a href="http://www.kevinmd.com/blog/post-author/rebekah-bernard" rel="tag" > Rebekah Bernard, MD < /a > Tags: Physician Medicare Source Type: blogs
Part Three: The Broader Impact of MACRA
Conclusion
This MACRA final rule is the start of a long journey in Medicare fee-for service payment reform, brought about by rare bipartisan Congressional compromise legislation based on the common understanding that for Medicare to achieve long-term sustainability, volume-based incentives need to be replaced with rewards for quality and patient-centered care. To come in future years are more rigorous targets, including scoring for cost performance with CMS providing clinical feedback to clinicians on their reported performance. We especially note the importance of MACRA for manufacturers, as APMs and MIPS will increasing...
Source: Policy and Medicine - December 11, 2016 Category: American Health Authors: Thomas Sullivan - Policy & Medicine Writing Staff Source Type: blogs
