NAACOS Analysis Shows ACOs In Top MIPS Performance Tier
|
|
- Hester Dawson
- 5 years ago
- Views:
Transcription
1 NAACOS Analysis Shows ACOs In Top MIPS Performance Tier The National Association of Accountable Care Organizations (NAACOS) is sharing results of its analysis of ACO performance in the Quality Payment Program (QPP) of the Merit Based Incentive Payment System (MIPS) created under the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA). Working with NAACOS, the firm of Dobson DaVanzo modeled the Alternative Payment Model (APM) scoring standard rules applicable to ACOs in MIPS and applied historical Track 1 ACO quality data to project 2017 ACO MIPS scores and their corresponding payment adjustments in MIPS. The analysis found that all 2017 Track 1 ACOs are likely to score well above the MIPS performance threshold, and most above the MIPS exceptional performance threshold, thereby receiving a positive MIPS payment adjustment. However, the overall ease at which MIPS clinicians may earn positive adjustments, coupled with budgetary restraints, indicates that most payment adjustments may be relatively small, ranging from 0.4 percent to 2.6 percent of qualified providers Part B expenditures. For more information on how ACOs are scored in MIPS, please refer to our ACO Guide to MACRA. ACOs commitment to quality improvement is clear. An August 2017 HHS Inspector General s report also found that Medicare ACOs improved performance on 82 percent of individual quality measures compared to their baseline and outperformed fee-for-service providers on 81 percent of quality measures. This analysis is further proof that ACOs hard work and dedication to quality improvement is paying off and should be rewarded by CMS. More detailed information about the analysis is included below. Key Findings All 2017 Medicare Shared Savings Program (MSSP) Track 1 ACOs included in the analysis are projected to earn a positive MIPS payment adjustment. The vast majority of 2017 MSSP Track 1 ACOs are projected to surpass the secondary MIPS scoring threshold for increased positive payment adjustments under most scoring scenarios tested. After applying CMS example scaling factors, the analysis projects ACOs would earn between a 0.4 percent and 2.4 percent positive payment adjustment under MIPS. Key Assumptions The analysis modeled the MIPS scoring methodology for the following performance categories: o Quality Performance Category Using ACO quality scores from PY2015 (the most recent available), utilizing PY2017 ACO benchmarks for MIPS. o Improvement Activities Performance Category Per CMS guidance, all ACOs will receive the maximum score automatically. o Advancing Care Information Category (ACI) The analysis made two main assumptions on ACO performance to create a range of possible outcomes: under the most optimistic scenario, the analysis assumes full credit is earned in the ACI performance category; under the most pessimistic scenario, the analysis assumes the ACO achieved the Base Score criteria of ACI.
2 The analysis modeled the MIPS payment adjustment methodology using the following assumptions: o Based on the combined scores and the score thresholds for a potential positive payment adjustments projected by CMS in the QPP final rule, the analysis determined the payment adjustments under three performance scenarios: most optimistic, intermediate (an average of the most optimistic and most pessimistic projections), and most pessimistic. o Payment adjustments were reduced by scaling factors for budget neutrality purposes as required by statute, relying on the scaling factors given as an example in the QPP final rule. MIPS payment adjustment projections were made for 264 out of 392 MSSP participant ACOs in Analysis of Key Findings CMS has established a 3-point minimum performance threshold and a 70-point exceptional performance threshold for the 2017 performance year. Under the most optimistic assumptions, all ACOs met or exceeded the exceptional performance threshold and would be eligible for maximum bonuses under MIPS.
3 Under the intermediate assumptions, all ACOs would score greater than 60 points, thereby earning bonuses and avoiding penalties under MIPS. However, only those scoring greater than or equal to the 70-point exceptional performance threshold would be eligible for the additional, exceptional performance bonus. Under the most pessimistic assumptions, all ACOs earn greater than 50 points and would avoid a penalty and earn bonuses under MIPS.
4 Given the low minimum performance threshold established by CMS for the 2017 performance year, even those earning the highest scores in MIPS will be eligible for only minimal bonuses given the program s budget neutrality requirements. In the most optimistic scenario, even those scoring a perfect score would be eligible for a meager 2.4 percent bonus in MIPS. Under the intermediate assumptions, bonuses would range between.5% and 1.9%.
5 Under the most pessimistic assumptions, bonuses would range between.4 percent and 1.3 percent. Additional Notes on Methodology: The weights for the MIPS performance categories under the APM Scoring Standard, as applicable to ACOs, were utilized: Quality (50 percent), Improvement Activities (20 percent), and ACI (30 percent). For performance year 2017 the Cost category has 0 percent weight MIPS payment adjustment projections are calculated for MSSP Track 1 ACOs, which by definition are the only APM under the MSSP that is required to participate in the MIPS For the Quality Performance Category (50 percent): o In scoring Quality, the analysis used 2015 MSSP performance scores (the most recently available quality performance data for MSSP ACOs). o The analysis only included current (2017) Track 1 ACOs, based on the 2017 CMS MSSP Organizations list. o The analysis excluded ACOs that did not report quality data in o Based on these exclusions, projections were made for 264 out of 392 MSSP participant ACOs in 2015.
PRIMER: MACRA and the Merit-based Incentive Payment System (MIPS) Tara O Neill Hayes January 31, 2016
PRIMER: MACRA and the Merit-based Incentive Payment System (MIPS) Tara O Neill Hayes January 31, 2016 Background On April 16, 2015, the Medicare Access and CHIP Reauthorization Act (MACRA) was signed into
More informationMACRA: THE FINAL RULE. Last updated 12/13/16
MACRA: THE FINAL RULE Last updated 12/13/16 1 Background April 2015 MACRA (Medicare Access & CHIP Reauthorization Act) is signed into law to repeal the sustainable growth rate (SGR) which drastically cut
More informationThe MACRA Proposed Rule on MIPS and APMs: Summary and Key Takeaways
The MACRA Proposed Rule on MIPS and APMs: Summary and Key Takeaways A White Paper May 2016 Impact Advisors LLC 400 E. Diehl Road Suite 190 Naperville IL 60563 1-800- 680-7570 Impact- Advisors.com Executive
More informationNext Generation Accountable Care Organization (ACO) Model Overview
The Physicians Advocacy Institute s Medicare Quality Payment Program (QPP) Physician Education Initiative Next Generation Accountable Care Organization (ACO) Model Overview Ad 1 P a g e MEDICARE QPP PHYSICIAN
More informationFAQs: Accountable Care Organizations (ACOs)
FAQs: Accountable Care Organizations (ACOs) ACOs are groups of doctors, hospitals, and other health care providers who voluntarily form partnerships to collaborate and share accountability for the quality
More informationCopyright Scottsdale Institute All Rights Reserved.
Copyright Scottsdale Institute 2017. All Rights Reserved. No part of this document may be reproduced or shared with anyone outside of your organization without prior written consent from the author(s).
More information4/8/17. The Changing Nature of Physician Payment and Health Care Reform in The AMA A Unifying Voice for Physicians
The Changing Nature of Physician Payment and Health Care Reform in 2017 U of Mo Family Medicine Update April 7, 2017 David Barbe, MD MHA President-elect American Medical Association VP Regional Operations
More informationMEDICARE ACCESS AND CHIP REAUTHORIZATION ACT (MACRA) MERIT-BASED INCENTIVE PAYMENT SYSTEM (MIPS) REVIEW
MEDICARE ACCESS AND CHIP REAUTHORIZATION ACT (MACRA) MERIT-BASED INCENTIVE PAYMENT SYSTEM (MIPS) REVIEW I. MIPS Overview 1) Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) i) Signed into Law
More informationMACRA Final Rule Summary
MACRA Final Rule Summary On October 14, 2016, the Centers for Medicare and Medicaid Services (CMS) released its final rule implementing the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA),
More informationMACRA: Alternative Payment Models Proposed Rule CY 2016
powered by Vizient & AAMC MACRA: Alternative Payment Models Proposed Rule CY 2016 June 2, 2016 Page 1 Housekeeping When you called in, did you enter your attendee ID number? Dial-in number: 1-866-469-3239
More informationThe Future Of Medicare Physician Reimbursement
Portfolio Media. Inc. 111 West 19 th Street, 5th Floor New York, NY 10011 www.law360.com Phone: +1 646 783 7100 Fax: +1 646 783 7161 customerservice@law360.com The Future Of Medicare Physician Reimbursement
More informationMedicare Releases Final Rule for the Second Year of the Quality Payment Program
Medicare Releases Final Rule for the Second Year of the Quality Payment Program On Nov. 2, 2017, CMS issued the Calendar Year 2018 Quality Payment Program (QPP) final rule for the second transition year
More informationMACRA, MIPS, APMs & CPC+: What to Expect from All These Acronyms?! Monthly National Briefing April 26, 2016
MACRA, MIPS, APMs & CPC+: What to Expect from All These Acronyms?! Monthly National Briefing April 26, 2016 1 Shari Erickson, MPH Vice President, Governmental Affairs & Medical Practice American College
More informationKey Financial and Operational Impacts from the Proposed Rule to Implement MACRA:
Key Financial and Operational Impacts from the Proposed Rule to Implement MACRA: The proposed rule implementing Access and CHIP Reauthorization Act of 2015 (MACRA) was made available on May 9, 2016. A
More informationCMS PROPOSES KEY PROVISIONS OF MACRA PHYSICIAN PAYMENT SYSTEM FOR 2019
Thursday, April 28, 2016 CMS PROPOSES KEY PROVISIONS OF MACRA PHYSICIAN PAYMENT SYSTEM FOR 2019 The Centers for Medicare & Medicaid Services (CMS) late yesterday issued a proposed rule implementing key
More informationMACRA and the Evolving Health Care Landscape. Jarrod Fowler, M.H.A. FMA Director of Health Care Policy and Innovation
MACRA and the Evolving Health Care Landscape Jarrod Fowler, M.H.A. FMA Director of Health Care Policy and Innovation MACRA The Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) Passed Congress
More informationMACRA Medicare Payment Reform and the Implications to Medicare Advantage Plans
BEYOND THE NUMBERS MACRA Medicare Payment Reform and the Implications to Medicare Advantage Plans True BUSINESS PowerPoint Presentation Template November 2018 PRESENTED BY Bob Moné, FSA, MAAA Liz Myers,
More informationGrowth and Success of Accountable Care Organizations (ACOs) in the US from Dennis Horrigan June 2016
Growth and Success of Accountable Care Organizations (ACOs) in the US from 2010-2016 Dennis Horrigan June 2016 Introducing Dennis Horrigan Dennis R. Horrigan President and Chief Executive Officer Catholic
More informationMACRA Update: The Top 8 For Amy Mullins, MD, CPE, FAAFP Medical Director, Quality Improvement AAFP
MACRA Update: The Top 8 For 2018 Amy Mullins, MD, CPE, FAAFP Medical Director, Quality Improvement AAFP Disclosure Statement It is the policy of the AAFP that all individuals in a position to control content
More informationMACRA: Redefining How CMS Pays Doctors. White Paper ELLIS MAC KNIGHT, MD DAN KIEHL, JD CONTACT. Senior Vice President/CMO. Associate Consultant
MACRA: Redefining How CMS Pays Doctors White Paper ELLIS MAC KNIGHT, MD Senior Vice President/CMO DAN KIEHL, JD Associate Consultant June 2016 CONTACT For further information about Coker Group and how
More informationTopics to be covered. Do I have to participate in MACRA/MIPS/QPP? Choices for participation. Timelines. What is changing with QPP
Topics to be covered Do I have to participate in MACRA/MIPS/QPP? Choices for participation Timelines What is changing with QPP I have no relevant financial relationships to disclose. Participant engagement
More informationAAOS MACRA Proposed Rule Summary (Short)
AAOS MACRA Proposed Rule Summary (Short) Merit-Based Incentive Payment System (MIPS), Advanced Alternative Payment Model (APM) Incentive, and Criteria for Physician-Focused Payment Models Ref: CMS-5517-P
More informationThe ACO Track One+ Model: New Rewards for Risk
The ACO Track One+ Model: New Rewards for Risk Executive Summary, May 2017 Accountable Care Organization Task Force AUTHOR Neal D. Shah Polsinelli PC Chicago, IL 1 This is an important year for Medicare
More informationYou Down with QPP? Daniel Collins Director of Finance Orlando Health Physician Enterprise
You Down with QPP? Daniel Collins Director of Finance Orlando Health Physician Enterprise Why Was the QPP created? Source: https://www.youtube.com/watch?v=7df7chghas4 What is QPP? Quality Payment Program
More informationAll About APMs: What Will It Take for Physicians to Earn the APM Bonus Under MACRA?
All About APMs: What Will It Take for Physicians to Earn the APM Bonus Under MACRA? By Robert F. Atlas, David B. Tatge, and Lesley R. Yeung June 2016 On May 9, 2016, the Centers for Medicare & Medicaid
More informationOther Payer Advanced APM Determination
Other Payer Advanced APM Determination Process: CMS Multi-Payer Models Quality Payment Program Final Rule for Year 2 On November 2, 2017, the Department of Health and Human Services (HHS) issued a final
More informationMACRA Overview. April 2016
MACRA Overview April 2016 CMS is Focused on Progression from Volume-Based to Value-Based Payments Hospitals have some value-based payment via Hospital VBP, readmissions, and HAC programs Other provider
More information2018 Quality Payment Program Final Rule. Summary
Summary On Thursday, November 3, 2017, CMS issued the 2018 Quality Payment Program (QPP) final rule. Comments on the final rule are due January 1, 2018. The QPP encompasses the Merit-based Incentive Payment
More informationMACRA: How the 2018 Quality Payment Program Final Rule Impacts Providers
Medical Group Strategy Council MACRA: How the 2018 Quality Payment Program Final Rule Impacts Providers Rob Lazerow Managing Director Tony Panjamapirom Senior Consultant Hamza Hasan Practice Manager Julie
More informationFact Sheet: 2019 Merit-based Incentive Payment System (MIPS) Payment Adjustments based on 2017 MIPS Final Scores
Fact Sheet: 2019 Merit-based Incentive Payment System (MIPS) Payment Adjustments based on 2017 MIPS Final Scores The Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) repealed the Medicare sustainable
More informationEverything You Need to Know About the MIPS Payment Adjustment
Everything You Need to Know About the MIPS Payment Adjustment Sandy Swallow and Michelle Brunsen June 12, 2018 1 This material was prepared by Telligen, the Medicare Quality Innovation Network Quality
More informationMedicare Quality Payment Program Overview (MACRA)
Medicare Quality Payment Program Overview (MACRA) December 2016 Rev. 12/1/16 Some general observations MACRA is complex More than a replacement for the SGR Many of the new requirements are revisions to
More informationSummary of the Quality Payment Program (QPP) Year 2 Final Rule
November 8, 2017 Summary of the Quality Payment Program (QPP) Year 2 Final Rule Medicare Program; CY 2018 Updates to the Quality Payment Program; and Quality Payment Program: Extreme and Uncontrollable
More information2018 Quality Measure Benchmarks Overview
2018 Quality Benchmarks Overview What Are Quality Benchmarks? When a clinician or group submits measures for the Merit-based Incentive Payment System (MIPS) quality performance category, each measure is
More informationMACRA: APPLICATIONS & IMPLICATIONS September 13, /13/2016. Mark Blessing, CPA, FHFMA Partner
MACRA: APPLICATIONS & IMPLICATIONS September 13, 2016 Mark Blessing, CPA, FHFMA Partner mblessing@bkd.com Zach Remmich Managing Consultant zremmich@bkd.com 1 TO RECEIVE CPE CREDIT Participate in entire
More information5 critical issues for BPCI-A
REPRINT June 2018 John M. Harris Molly Johnson Amanda Brown healthcare financial management association hfma.org 5 critical issues for BPCI-A Many hospitals and health systems may benefit from participation
More informationDecember 19, Dear Acting Administrator Slavitt:
December 19, 2016 Mr. Andrew Slavitt Acting Administrator Centers for Medicare & Medicaid Services U.S. Department of Health and Human Services Hubert H. Humphrey Building 200 Independence Avenue, S.W.
More informationMACRA and Medicare Advantage
MACRA and Medicare Advantage Lynn Dong, FSA, MAAA Christopher Kunkel, FSA, MAAA, PhD April 6, 2017 Caveats and limitations This presentation and question and answer session is not intended to be an actuarial
More informationScripps Health ACO Update
June 2016 Scripps Health ACO Update Marc Reynolds Senior Vice President, Payer Relations Scripps Health Anil N. Keswani, MD Corporate Vice President, Population Health Management Scripps Health 10 Key
More informationPredictive Qualifying Alternative Payment Model (APM) Participants (QPs) Methodology Fact Sheet What is the Predictive QP Status Analysis?
Predictive Qualifying Alternative Payment Model (APM) Participants (QPs) Methodology Fact Sheet What is the Predictive QP Status Analysis? One of the Quality Payment Program s goals is to be clear about
More informationHealth Care Policy Landscape: Market Trends & Frontline Perspectives
Health Care Policy Landscape: Market Trends & Frontline Perspectives December 1, 2016 www.leavittpartners.com Post-Election, New Administration Insights Top 10 Health Policy Actions to Watch 1 2 3 4 Substantial
More information2018 Merit-Based Incentive Payment System (MIPS) Scoring Overview
The Physicians Advocacy Institute s Medicare Quality Payment Program (QPP) Physician Education Initiative 2018 Merit-Based Incentive Payment System (MIPS) Scoring Overview 1 P a g e MEDICARE QPP PHYSICIAN
More informationNAACOS Policy Recommendations
NAACOS Policy Recommendations The National Association of ACOs (NAACOS) appreciates the opportunity to provide details policy recommendations needed to solidify the Medicare ACO program and set Medicare
More informationCY 2018 Quality Payment Program Final Rule Summary
CY 2018 Quality Payment Program Final Rule Summary On November 2, 2017, the Centers for Medicare and Medicaid Services (CMS) released its final rule outlining the requirements for year two of the Quality
More informationMACRA: New Medicare Reimbursement Models Sharp HealthCare
MACRA: New Medicare Reimbursement Models Sharp HealthCare August 15, 2016 Nathan M. Bays, Esq. General Counsel, The Health Management Academy Executive Director, Advisors Caitlin Greenbaum, MPH Director,
More informationAMERICAN COLLEGE OF GASTROENTEROLOGY MAKING $ENSE OF MACRA
AMERICAN COLLEGE OF GASTROENTEROLOGY 6400 Goldsboro Road, Suite 200, Bethesda, Maryland 20817-5842; P: 301-263-9000; F: 301-263-9025 MAKING $ENSE OF MACRA CMS.SGR MACRA MIPS APMs QCDRs ACOs Why does Washington
More informationA PRIMER FOR PRIMARY CARE
MACRA / MIPS Transition to value-based payment in Medicare A PRIMER FOR PRIMARY CARE Robert Resnik MD MBA Source: CMS What does MACRA Accomplish? Repeals the Sustainable Growth Rate (SGR) Formula Changes
More informationBuilding Capacity for Value. Missouri Rural Health Conference August 15, 2017
1 Building Capacity for Value Missouri Rural Health Conference August 15, 2017 Rural Health Value 2 Vision: To build a knowledge base through research, practice, and collaboration that helps create high
More informationWebinar: Impact of ACOs on MIPS Payments
Webinar: Impact of ACOs on MIPS Payments a HealthcareWebSummit Event, 1PM Eastern, Wednesday, May 17th, 2017 Individual Registration Fee: $95. Post-Event Materials: $45 for attendees; $160 for non-attendees
More informationAMERICAN COLLEGE OF GASTROENTEROLOGY MAKING $ENSE OF MACRA
AMERICAN COLLEGE OF GASTROENTEROLOGY 6400 Goldsboro Road, Suite 200, Bethesda, Maryland 20817-5842; P: 301-263-9000; F: 301-263-9025 MAKING $ENSE OF MACRA CMS.SGR MACRA MIPS APMs QCDRs ACOs Why does Washington
More information9/7/17. MACRA: The Knowns and the Unknowns. Disclosures. Goals and Objectives
MACRA: The Knowns and the Unknowns Sharon K. Merrick, M.S., CCS-P Director of Payment and Practice Management American Society of Anesthesiologists Wisconsin Society of Anesthesiologists September 10,
More informationGet Straight on MACRA in 2018
Quality Reporting Roundtable Get Straight on MACRA in 2018 FAQs, Advisory Board Guidance, and Resources Ye Hoffman, MS, CPHIMS Consultant March 27, 2018 research technology consulting 2 Manage Your Audio
More informationHealth care affordability VBC transformation
Health care affordability VBC transformation What s at stake? The cost of health care in the United States has been on an unsustainable rise for some time, driven by fundamental delivery and financing
More informationQUALITY PAYMENT PROGRAM YEAR 3 (2019) FINAL RULE OVERVIEW NOVEMBER 15, 2018
QUALITY PAYMENT PROGRAM YEAR 3 (2019) FINAL RULE OVERVIEW NOVEMBER 15, 2018 Disclaimers This presentation was prepared as a tool to assist providers and is not intended to grant rights or impose obligations.
More informationThank you, and enjoy the webinar.
Disclaimer This webinar may be recorded. This webinar presents a sampling of best practices and overviews, generalities, and some laws. This should not be used as legal advice. Itentive recognizes that
More informationThe Road to Value. Aric R. Sharp, MHA, CMPE, FACHE Vice President Accountable Care UnityPoint Health February 3, 2017
The Road to Value Aric R. Sharp, MHA, CMPE, FACHE Vice President Accountable Care UnityPoint Health February 3, 2017 1,500 Physicians UnityPoint Clinic 17 hospitals + 15 rural network hospitals 35,000
More informationProposed 2018 Medicare Physician Payment and Quality Reporting Changes. Executive s Insights
Proposed 2018 Medicare Physician Payment and Quality Reporting Changes MGMA MEMBER-EXCLUSIVE ANALYSIS The Centers for Medicare & Medicaid Services (CMS) recently proposed changes to both Medicare physician
More informationQUALITY PAYMENT PROGRAM YEAR 3 (2019) FINAL RULE OVERVIEW
QUALITY PAYMENT PROGRAM YEAR 3 (2019) FINAL RULE OVERVIEW NEAL LOGUE, HEALTH INSURANCE SPECIALIST, DIVISION OF FINANCIAL MANAGEMENT & FEE FOR SERVICE OPERATIONS DECEMBER 12, 2018 Disclaimers This presentation
More informationACOs at a Crossroads: Cost, Risk and MACRA. Allison Brennan, Vice-President of Policy Clif Gaus, President and CEO.
National Association of ACOs ACOs at a Crossroads: Cost, Risk and MACRA Allison Brennan, Vice-President of Policy Clif Gaus, President and CEO www.naacos.com ACOs at a Crossroads: Costs, Risk and MACRA
More informationA Practical Discussion of Value and Quality Based Payments What Do I Do Now?
Emerging Challenges in Primary Care: 2016 A Practical Discussion of Value and Quality Based Payments What Do I Do Now? Modified from AHLA Physicians and Hospitals Law Institute 2016 Faculty Ellie Bane
More informationNational Association of ACOs. ACO Cost and MACRA Implementation Survey. May
National Association of ACOs ACO Cost and MACRA Implementation Survey May 2016 www.naacos.com ACO Cost and MACRA Implementation Survey 1 May 2016 Dear ACO Colleague: We are pleased to release the results
More informationFederal Update Issues Impacting Rheumatologists and their Patients. Emily L. Graham, RHIA, CCS-P VP, Regulatory Affairs Hart Health Strategies, Inc.
Federal Update Issues Impacting Rheumatologists and their Patients Emily L. Graham, RHIA, CCS-P VP, Regulatory Affairs Hart Health Strategies, Inc. Just a spoon full of DC? Agenda MACRA & Rheumatology
More informationWHERE THE FRONT LINE MEETS THE BOTTOM LINE: THE HEALTHCARE SYSTEM OF THE FUTURE
WHERE THE FRONT LINE MEETS THE BOTTOM LINE: THE HEALTHCARE SYSTEM OF THE FUTURE AFT Nurses and Health Professionals Professional Issues Conference 2016 Fred Hyde, MD April 21, 2016 Trends for 2016-2022:
More informationAlternative Payment Models in the Quality Payment Program as of November 2018
Alternative Payment s in the Payment Program as of November 2018 The table below displays the Alternative Payment s (s) that CMS currently operates or has announced, as of November 2018. In the table,
More informationHealth IT Public Policy Update
Health IT Public Policy Update January 21, 2016 Tom Leary HIMSS Vice President Government Relations HHS Set Firm Goals for the Move to Value-Based Care Health Information Technology for Economic and Clinical
More informationVolume to Value The Great Transformation of American Medicine
Volume to Value The Great Transformation of American Medicine 2010-2020 Richard I. Fogel, MD FHRS Chief Clinical Officer St. Vincent Health October 2015 Fee for Service You get paid for what you do The
More informationHEALTH ECONOMICS AND REIMBURSEMENT
HEALTH ECONOMICS AND REIMBURSEMENT VASCULAR CY 2016 MEDICARE PHYSICIAN FEE SCHEDULE (PFS) UPDATE Abbott Vascular is pleased to provide you with this summary of the Medicare Physician Fee Schedule (PFS)
More informationWashington Update. Mollie Gelburd, JD - 1 -
Washington Update Mollie Gelburd, JD mgelburd@mgma.org - 1 - Agenda Political and regulatory environment Trending topics Medicare physician payment reform: Mid-year status report Practice executive s watch
More informationOn Track for MACRA The Provider s Guide to QPP
On Track for MACRA The Provider s Guide to QPP Bizmatics, Inc. 4010 Moorpark Avenue, Suite 222 San Jose, CA 95117 www.prognocis.com training@bizmaticsinc.com Copyright 2017 Bizmatics, Inc. Overview CMS
More informationFirst a word about the rising cost of retiree healthcare
Medicare Trends First a word about the rising cost of retiree healthcare The average 66-year-old couple is expected to spend nearly 60% of their Social Security income on medical bills, according to a
More informationCMS 1701 P UnityPoint Health. October 16, 2018
CMS 1701 P UnityPoint Health 1776 West Lakes Parkway, Suite 400 West Des Moines, IA 50266 unitypoint.org October 16, 2018 Seema Verma, Administrator Centers for Medicare & Medicaid Services Department
More informationWashington Update. Suzanne Falk, MPP Associate Director, Government Affairs
Washington Update Suzanne Falk, MPP Associate Director, Government Affairs sfalk@mgma.org Agenda 2017 Medicare Physician Fee Schedule Highlights Miscellaneous Updates 2016 Quality Reporting Wrap-Up Quality
More informationMedicare Access and CHIP Reauthorization Act of 2015 (HR. 2; MACRA)
Fact Sheet April 23, 2015 H.R.2 - Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) Background. The Medicare Sustainable Growth Rate formula (SGR), passed by Congress in 1997, was intended to
More informationNew Medicare Merit-Based Incentive Payment System: Navigating Changes Under MACRA
Presenting a live 90-minute webinar with interactive Q&A New Medicare Merit-Based Incentive Payment System: Navigating Changes Under MACRA Overcoming Challenges in Transforming Payment and Care Delivery
More informationUnderstanding and Facilitating Rural Health Transformation
Understanding and Facilitating Rural Health Transformation 2017 Center for Rural Health Annual Meeting St. Simons Island, Georgia August 16, 2017 A. Clinton MacKinney, MD, MS Clinical Associate Professor
More informationMarch 1, Chairman Lamar Alexander United States Senate Committee on Health, Education, Labor, and Pensions Washington, DC 20510
March 1, 2019 Chairman Lamar Alexander United States Senate Committee on Health, Education, Labor, and Pensions Washington, DC 20510 Dear Chairman Alexander: On behalf of AMGA and our members, I appreciate
More informationRUPRI Center for Rural Health Policy Analysis. Rural Policy Brief. Brief No NOVEMBER
RUPRI Center for www.banko Rural Health Policy Analysis Rural Policy Brief Brief No. 2018-6 NOVEMBER 2018 http://www.public-health.uiowa.edu/rupri/ Changes to the Merit-based Incentive Payment System Pertinent
More informationClinically Integrated Networks and Population Health The next chapter in healthcare
Clinically Integrated Networks and Population Health The next chapter in healthcare M A T T H E W M A T U S I A K, D H S C, F R I P H ( UK) M T ( A S C P ) Health System Challenges While the Uninsured
More informationValuation of Alternative Payment Models
Valuation of Alternative Payment Models No portion of this white paper may be used or duplicated by any person or entity for any purpose without the express written permission of PYA. I. Introduction:
More informationICLIO National Conference
ICLIO National Conference Alternative Payment Models and Methods Potential Impact of I-O Therapies Jennifer Hinkel, MSc Partner, McGivney Global Advisors 9.30.16 Philadelphia, Pa. accc-iclio.org Alternative
More informationCMS Quality Payment Program
CMS Quality Payment Program Guide for Managed Care Organizations Providing State Medicaid Agencies with Information and Documentation for Submitting Medicaid Requests for Other Payer Advanced APM Determinations
More informationCurrent State of Medicare. Robert Roth & John Hellow Hooper, Lundy & Bookman, PC
Current State of Medicare Robert Roth & John Hellow Hooper, Lundy & Bookman, PC Rule for FY 2016 A. FY 2017 Final Rule Released Aug. 2, 2016 (printed in Federal Register Aug. 22, 2016) B. FY 2018 Proposed
More informationCurrent State of Medicare
Current State of Medicare Robert Roth & John Hellow Hooper, Lundy & Bookman, PC Rule for FY 2016 A. FY 2017 Final Rule Released Aug. 2, 2016 (printed in Federal Register Aug. 22, 2016) B. FY 2018 Proposed
More informationQuality Payment Program Year 2
Quality Payment Program Year 2 MIPS Highlights Raising the performance threshold to 15 points in Year 2 (from 3 points in the transition year). Allowing the use of 2014 Edition and/or 2015 Certified Electronic
More informationSummary of proposed rule provisions for Accountable Care Organizations under the Medicare Shared Savings Program
DEPARTMENT OF HEALTH & HUMAN SERVICES Centers for Medicare & Medicaid Services Room 352-G 200 Independence Avenue, SW Washington, DC 20201 Office of Media Affairs MEDICARE FACT SHEET FOR IMMEDIATE RELEASE
More informationPhysician Compensation In Today s Changing Market
Physician Compensation In Today s Changing Market PRESENTED BY: STEVE RICE, AREA PRESIDENT, INTEGRATED HEALTHCARE STRATEGIES STEVE MCCAMY, PRESIDENT AND CEO OF COVENANT MEDICAL GROUP NOVEMBER 9, 2016 Agenda
More informationMoving to Accountable Care through the ACA & MACRA
Moving to Accountable Care through the ACA & MACRA Jim Whitfill, MD President Lumetis, LLC Clinical Associate Professor, Departments of Internal Medicine and Biomedical Informatics University of Arizona
More informationWashington Update. Suzanne Falk, MPP Associate Director, Government Affairs
Washington Update Suzanne Falk, MPP Associate Director, Government Affairs sfalk@mgma.org Agenda 2017 Medicare Physician Fee Schedule Changes Miscellaneous Updates 2016 Quality Reporting Wrap-Up MACRA
More informationa HealthcareWebSummit Event, 1PM Eastern, Wednesday, March 29, 2017
Webinar: MACRA and Medicare Advantage a HealthcareWebSummit Event, 1PM Eastern, Wednesday, March 29, 2017 Individual Registration Fee: $195. Post-Event Materials: $45 for attendees; $260 for non-attendees
More informationQuality Payment Program Year 3
Quality Payment Program Year 3 Final Rule Overview The Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) ended the Sustainable Growth Rate (SGR) formula for clinician payment, and established
More information9/23/2016. Our Services. Transitioning from Fee-for-Service to Value-based Reimbursement. Key Trends and Strategies for Rural Health Providers
Transitioning from Fee-for-Service to Value-based Reimbursement Key Trends and Strategies for Rural Health Providers Paul MacLellan, CEO >> Health care consulting company >> Wholly owned subsidiary of
More informationMedicare Red Tape Relief Project Submissions accepted by the Committee on Ways and Means, Subcommittee on Health
Please Provide Responses to the Fields Below Electronically to be Accepted Medicare Red Tape Relief Project Submissions accepted by the Committee on Ways and Means, Subcommittee on Health Date: August
More informationValue-Based Purchasing and Bundled Services/ Payments Reconciling Interests of Participating Providers
PRESENTED AT The University of Texas School of Law 30 th Annual Health Law Conference April 4-6, 2018 Houston, TX Value-Based Purchasing and Bundled Services/ Payments Reconciling Interests of Participating
More informationTotal Cost of Care Workgroup. July 26, 2017
Total Cost of Care Workgroup July 26, 2017 Agenda Updates on initiatives with CMS Review of MPA options Updated HSCRC numbers on attribution approaches for assigning Medicare TCOC 2 Updates on Initiatives
More informationCMS Proposes Changes to the MSSP Benchmarking Methodology
Policy Brief February 3, 2016 CMS Proposes Changes to the MSSP Benchmarking Methodology On January 28 th CMS released the proposed rule updating the benchmarking methodology for renewing ACOs in the Medicare
More informationPREPARING FOR THE NEXT GENERATION OF MANAGED CARE CONTRACTING
PREPARING FOR THE NEXT GENERATION OF MANAGED CARE CONTRACTING Nanci Robertson, RN BSN President - Robertson Consulting, Inc. Doral Jacobsen, MBA FACMPE CEO - Prosper Beyond, Inc. DORAL JACOBSEN AND NANCI
More informationThe ACO Effort: A Status Report
1 The ACO Effort: A Status Report J. Mark Waxman mwaxman@foley.com 617-342-4055 2 Whats the fuss about? A need for accountability for cost and quality A belief that the system can improve if: Provider
More informationACOs/Shared Savings Demonstration Project: What Does It All Mean?
ACOs/Shared Savings Demonstration Project: What Does It All Mean? None Conflicts of Interest Sean P. Roddy, MD Albany, NY Accountable Care Organizations Term introduced in 2006 by Fisher et al. the hospital
More informationDeveloping Your Value Proposition. Timothy P. McNeill, RN, MPH
Developing Your Value Proposition Timothy P. McNeill, RN, MPH What is a Value Proposition A value proposition is the service or feature that makes an organization attractive to potential customers The
More informationFinal Policy, Payment, and Quality Provisions in the Medicare Physician Fee Schedule for Calendar Year 2018
Final Policy, Payment, and Quality Provisions in the Medicare Physician Fee Schedule for Calendar Year 2018 Date 2017-11-02 Title Contact Final Policy, Payment, and Quality Provisions in the Medicare Physician
More information