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Hire more staff to help deal with MACRA?


An article in Physicians Practice looks at the pros and cons or hiring additional staff to address MACRA issues. Among the stuff:

The article asserts that Charles Saunders, M.D.,  who is CEO of Integra Connect, a technology and service provider specializing in value-based care,  is one of the few experts who says that hiring more staff may be necessary.

The article reports:  “He says this is the case if a practice chooses to participate in the other MACRA pathway, an advanced alternative payment model (APM). These models have requirements for certain activities such as care coordination and quality improvement programs, which can’t simply be automated. ‘To be successful in driving savings, some investments in these activities will be required for care coordinators and case managers,’ he says. This is because, as with MIPS measures, reporting on them can be a labor-intensive exercise requiring chart reviews, depending on the ability of the EHR to automate this process.”

“Other experts disagree, suggesting that MACRA shouldn’t radically change the way physicians staff their practice or collect information from their patients. ‘In effect, MACRA simply is a requirement that physicians document that they’ve actually performed the next step in terms of a slightly more complicated process of documentation,’ says Stuart Hochron, M.D., chief medical officer and co-founder of Uniphy Health, a physician’s communication and collaboration app. He says the changes won’t require new staff, just more staff education. He recommends turning to CMS’s extensive online resources on the topic, as well as medical societies that offer MACRA education as a start. ‘I’d either attend a respectable conference that was targeted as your organization is focused, or hire a consultant,’  he says.”

To read the whole article, please hit this link.

Things to know about CMS’s Oncology Care Model


Here is a stripped-down version of Becker’s Hospital Review’s “9 things to know” about CMS’s five-year Oncology Care Model, one of  CMS’s first physician-led specialty-care models, meant to improve quality and cut  costs.

1. “HHS selected 17 payers and 196 physician practices to participate — almost twice the number it expected.”

2. “The program takes  episodic approach to cancer treatment to help contain costs and enhance patient care.”

3. “Under the OCM, physicians are paid in two ways.”

4. “Episodes last six months each and cover almost all cancer types.”

5. “Performance payments are awarded to practices based on how well they perform in relation to benchmarks calculated by CMS.”

6. “There are two risk options under the OCM.”

7. “The two-sided risk track is considered an Advanced Alternative Payment Model under the newly proposed Medicare Access and CHIP Reauthorization Act.”

8. “CMS will provide a learning system for participants to share and diffuse resources, tools, ideas and data-driven approaches to care.”

9. “Dual participation in OCM and other programs is allowed in some cases.”

To read the whole Becker’s article, please hit this link.


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