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Quality Payment Program

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Bill seeks to ease Meaningful Use demands on hospitals

 

bipartisan group has introduced a bill in the U.S. House that would apparently let the U.S. Department of Health and Human Services (HHS)  ease the burden on hospitals (apparently hospitals only) of Meaningful Use rules involving Medicare recipients.

Called an effort to “amend title XVIII of the Social Security Act to reduce the volume of future electronic health-related significant hardship requests,” the bill would  only affect  providers  still subject to the government’s electronic health record (EHR) incentive program, known as ‘Meaningful Use,”’  Robert Tennant, senior policy adviser to the Medical Group Management Association, told Medscape.

CMS no longer requires individual physicians to participate in the Meaningful Use program, which for them has been subsumed by the Quality Payment Program (QPP) of the Centers for Medicare and Medicaid Services. And, Mr. Tennant said, physicians   eligible to participate in the Medicaid portion of Meaningful Use are not penalized if they don’t participate.

He explained that the legislation might ease their Meaningful Use reporting, but any hardship exceptions would not affect them.

To read more, please hit this link.


Why direct primary care beats MACRA

 

John Squire, President and COO of Amazing Charts, writes in Med City News that direct primary care (DPC) has MACRA’s goals but without the complexity. (A reminder: MACRA stands for  Medicare Access and CHIP Reauthorization Act of 2015.)

He writes:

“When I first heard about the federal government’s new value-based Quality Payment Program for physicians, I was struck by the similarities with direct primary care, a grassroots movement that seeks to establish a straight financial relationship between patients and providers, cutting out private insurance carriers and Medicare. The premise of direct primary care is that patients pay providers directly, usually in the form of a low monthly subscription.”

“The ways these goals are achieved by direct care and MACRA/MIPS are incredibly similar. Both approaches focus on: enhanced access to the practice; proactive care for chronic conditions and preventive diseases; patient and caregiver engagement; and coordination of care across the medical neighborhood. But the ways of administering care and measuring results is dramatically different.”

“Direct primary care is growing in popularity, fueled by physician discontent with the traditional fee-for-service model that encourages 15-minutes-or-less exams with an overwhelming number of appointments. Patients typically join a DPC practice as a ‘member’ and pay a flat monthly fee (about $75) for virtually unlimited primary care, including extended in-office visits, as well as non-face-to-face care via email, phone and text. As a result, patients visit DPC doctors more often and develop stronger personal bonds.”

To read the article, please hit this link.


CMS widens options for APMs

CMS  offering additional opportunities for physicians and other clinicians to join advanced Alternative Payment Models beginning in 2017 and 2018.

The advanced Alternative Payment Model is the more lucrative of two options under the Medicare Access and CHIP Reauthorization Act, (MACRA) a payment system for Medicare physician fees that replaces the controversial Sustainable Growth Rate formula.

CMS will offer the Oncology Care Model with two-sided risk as a qualifying advanced APM beginning in 2017 and  will reopen applications for the Comprehensive Primary Care Plus model and the Next Generation ACO model for the 2018 performance year.

Patrick Conway, M.D., deputy CMS Administrator,  said:

“With these new opportunities, CMS expects that by the 2018 performance period, 25 percent of clinicians in the Quality Payment Program will earn incentive payments by being a part of these advanced models. Thanks to MACRA and the Innovation Center, we’re striving to see more Medicare patients benefit from better care when they visit their doctor for a knee replacement, receive cancer treatment or have a coordinated care team manage their complex conditions.”

Physicians who participate in Medicare must submit at least some performance data next year to avoid a penalty under MACRA. These data will determine payment adjustments beginning in 2019. Physicians who qualify as an advanced APM will avoid some reporting requirements and be eligible for a 5 percent lump-sum bonus.

To read a Becker’s Hospital Review article on this, please hit this link.


Getting small practices into quality program

 

Here’s a  update on how  small medical practices  are being encouraged to transition into the Feds’ Quality Payment Program with the help of federal funding.

The transition won’t all be easy.

To read the Medical Economics on this, please hit this link.


CMS releases stronger incentives to join ACOs

CMS has released final regulatory revisions  to strengthen incentives for Accountable Care Organizations in the Medicare Shared Savings Program.

CMS Acting Administrator Andy Slavitt said the changes  will “encourage more physicians to improve patient care by joining ACOs, while also refining how the program measures success, so that current participants are better rewarded for quality.”

Mr. Slavitt said the changes will also help physicians prepare for the new Quality Payment Program That program will hold providers to unprecedented accountability not just for reporting, but also, among large physician groups, for performance on a broad range of behaviors.

Here, according to Becker’s Hospital Review, are five takeaways from the MSSP ACO final rule.

1. “CMS modified the process for resetting benchmarks used to determine ACO performance.”

2. “CMS removed the adjustment that explicitly accounts for savings generated under an ACO’s prior agreement period.”

3. “The rule includes a phased-in approach to implementation.”

4. “CMS finalized an additional option for ACOs participating under Track 1 to apply to renew for a second agreement period under a two-sided model.”

5. “The rule establishes timeframes and criteria for ACOs to appeal CMS’ calculation of bonuses and penalties.”

 


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