Resources

JUDGING THE QUALITY OF QUALITY MEASURES

By the end of 2018, the Centers for Medicare and Medicaid Services (CMS) intends to tie 90% of payments to Medicare fee-for-service clinicians to their performance on quality measures. The Merit-Based Incentive Payment System (MIPS) consists of 271 such measures which were designed to provide an objective yardstick to identify and financially reward those physicians who provide the highest quality care to their patients. To ensure that they are able to participate in these incentive programs, which can result in Learn More “JUDGING THE QUALITY OF QUALITY MEASURES”

PROGRAMS DESIGNED TO LOWER HEALTHCARE COSTS HAVE THE OPPOSITE EFFECT

Remember the Institute for Healthcare Improvement’s Triple Aim? First proposed in 2007, this ambitious initiative was supposed to improve the patient experience, improve population health, and – here comes the best part – reduce costs. Healthcare has changed dramatically since 2007. The Affordable Care Act sought to reduce costs and improve population health by shifting the financial levers that incentivized expensive interventions and instead incentivizing prevention and wellness. But have either the Triple Aim or the goals of the ACA Learn More “PROGRAMS DESIGNED TO LOWER HEALTHCARE COSTS HAVE THE OPPOSITE EFFECT”

DATA REPORTING IS KEY FOR SUCCESS IN VBP: CHALLENGES AND COST

In the Value-Based Payment world (VBP), physicians are financially rewarded or penalized depending on the quality of care they provide or the outcomes their patients achieve. In order to determine which providers win and which lose in this scenario, data analysis is essential. This means that providers – many of whom only recently began implementing electronic health records – are now responsible for managing a tremendous volume of patient data. This responsibility comes at a high cost. Challenge #1 – Learn More “DATA REPORTING IS KEY FOR SUCCESS IN VBP: CHALLENGES AND COST”

SMALL, INDEPENDENT PRACTICES ARE AN UNINTENDED CASUALTY OF HEALTHCARE REFORM

In January 2009, Barack Obama was inaugurated as the 44th President of the United States. With healthcare reform as one of his major initiatives, the Affordable Care Act, also known as Obamacare, became law in 2010. Among the many levers embedded in this massive and ambitious legislation are incentive programs designed to completely shift the focus of the American healthcare system, from disease management to population health management. While the underlying theories driving this shift may be based on sound Learn More “SMALL, INDEPENDENT PRACTICES ARE AN UNINTENDED CASUALTY OF HEALTHCARE REFORM”