Inside Medicare's New Payment System

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Changes to the Medicare payment system are on the horizon, and physicians around the country are wondering how the new Medicare Access and CHIP Reauthorization Act (MACRA) will impact their practices. This series from the American Medical Association provides an inside look at what’s to come and wha…

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    • Mar 17, 2020 LATEST EPISODE
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    • 79 EPISODES


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    Latest episodes from Inside Medicare's New Payment System

    The AMA Opioid Task Force Calls for Individualized Care for Patients with Pain

    Play Episode Listen Later Mar 17, 2020


    Guest: David Ring, MD, PhD Guest: Ameet Nagpal, MD Guest: Steven P. Stanos, Jr., DO Individualized healthcare is extremely important for patients with pain, but physicians and patients face barriers for such care. Drs. David Ring, Ameet Nagpal, and Steven Stanos sat down with us to provide insight on how the 2019 AMA Opioid Task Force is working to support individualized care for patients with pain.

    The American Medical Association Opioid Task Force: Support for Evidence-Based Care for Substance Use Disorders

    Play Episode Listen Later Mar 17, 2020


    Guest: Patrice Harris, MD Guest: Frank Dowling, MD Guest: Elizabeth Salisbury-Afshar, MD Guest: Sharon Levy, MD, MPH Guest: John Renner, MD As the nation’s opioid epidemic has now become a deadlier drug overdose epidemic, the AMA Opioid Task Force urges individualized and evidence-based patient care for those with a substance use disorder. Offering their unique perspectives on how to help patients, physician members of the AMA Opioid Task Force shared their perspectives on helping patients with a substance use disorder. Drs. Patrice Harris, Frank Dowling, Elizabeth Salisbury-Afshar, Sharon Levy, and John Renner.

    The AMA Opioid Task Force Calls for Individualized Care for Patients with Pain

    Play Episode Listen Later Mar 16, 2020


    Guest: David Ring, MD, PhD Guest: Ameet Nagpal, MD Guest: Steven P. Stanos, Jr., DO Individualized healthcare is extremely important for patients with pain, but physicians and patients face barriers for such care. Drs. David Ring, Ameet Nagpal, and Steven Stanos sat down with us to provide insight on how the 2019 AMA Opioid Task Force is working to support individualized care for patients with pain.

    The American Medical Association Opioid Task Force: Support for Evidence-Based Care for Substance Use Disorders

    Play Episode Listen Later Mar 16, 2020


    Guest: Patrice Harris, MD Guest: Frank Dowling, MD Guest: Elizabeth Salisbury-Afshar, MD Guest: Sharon Levy, MD, MPH Guest: John Renner, MD As the nation’s opioid epidemic has now become a deadlier drug overdose epidemic, the AMA Opioid Task Force urges individualized and evidence-based patient care for those with a substance use disorder. Offering their unique perspectives on how to help patients, physician members of the AMA Opioid Task Force shared their perspectives on helping patients with a substance use disorder. Drs. Patrice Harris, Frank Dowling, Elizabeth Salisbury-Afshar, Sharon Levy, and John Renner.

    The AMA Opioid Task Force Calls for Individualized Care for Patients with Pain

    Play Episode Listen Later Mar 16, 2020


    Guest: David Ring, MD, PhD Guest: Ameet Nagpal, MD Guest: Steven P. Stanos, Jr., DO Individualized healthcare is extremely important for patients with pain, but physicians and patients face barriers for such care. Drs. David Ring, Ameet Nagpal, and Steven Stanos sat down with us to provide insight on how the 2019 AMA Opioid Task Force is working to support individualized care for patients with pain.

    The American Medical Association Opioid Task Force: Support for Evidence-Based Care for Substance Use Disorders

    Play Episode Listen Later Mar 16, 2020


    Guest: Patrice Harris, MD Guest: Frank Dowling, MD Guest: Elizabeth Salisbury-Afshar, MD Guest: Sharon Levy, MD, MPH Guest: John Renner, MD As the nation’s opioid epidemic has now become a deadlier drug overdose epidemic, the AMA Opioid Task Force urges individualized and evidence-based patient care for those with a substance use disorder. Offering their unique perspectives on how to help patients, physician members of the AMA Opioid Task Force shared their perspectives on helping patients with a substance use disorder. Drs. Patrice Harris, Frank Dowling, Elizabeth Salisbury-Afshar, Sharon Levy, and John Renner.

    Changes to Reporting Evaluation & Management Office Visits: How to Prepare for 2021

    Play Episode Listen Later Dec 31, 2019


    Guest: Barbara Levy, MD Guest: Peter A. Hollmann, MD On Nov. 1, CMS announced that Medicare will implement these changes on January 1, 2021. Physicians will no longer be required to engage in unnecessary and burdensome documentation to report office visits. The new framework will provide physicians with reporting by either total time spent on the date of the visit or the medical decision-making used in the provision of the service. Doctors Peter Hollmann and Barbara Levy will also explain the AMA/Specialty Society RVS Update Committee’s recommendations to increase the valuation of office visits.

    Changes to Reporting Evaluation & Management Office Visits: How to Prepare for 2021

    Play Episode Listen Later Dec 30, 2019


    Guest: Barbara Levy, MD Guest: Peter A. Hollmann, MD On Nov. 1, CMS announced that Medicare will implement these changes on January 1, 2021. Physicians will no longer be required to engage in unnecessary and burdensome documentation to report office visits. The new framework will provide physicians with reporting by either total time spent on the date of the visit or the medical decision-making used in the provision of the service. Doctors Peter Hollmann and Barbara Levy will also explain the AMA/Specialty Society RVS Update Committee’s recommendations to increase the valuation of office visits.

    Changes to Reporting Evaluation & Management Office Visits: How to Prepare for 2021

    Play Episode Listen Later Dec 30, 2019


    Guest: Barbara Levy, MD Guest: Peter A. Hollmann, MD On Nov. 1, CMS announced that Medicare will implement these changes on January 1, 2021. Physicians will no longer be required to engage in unnecessary and burdensome documentation to report office visits. The new framework will provide physicians with reporting by either total time spent on the date of the visit or the medical decision-making used in the provision of the service. Doctors Peter Hollmann and Barbara Levy will also explain the AMA/Specialty Society RVS Update Committee’s recommendations to increase the valuation of office visits.

    The Implications of a Potential Single-Payer Healthcare System

    Play Episode Listen Later Oct 3, 2019


    Host: Amy Mackey, MD Guest: Cynthia Brown To learn more about the potential pros and cons of a single-payer healthcare system for both physicians and patients—and even the likelihood of our country adopting such a system—Dr. Amy Mackey is joined by a representative from the American Medical Association (AMA): Vice President of Government Affairs Cynthia Brown.

    The Implications of a Potential Single-Payer Healthcare System

    Play Episode Listen Later Oct 3, 2019


    Host: Amy Mackey, MD Guest: Cynthia Brown To learn more about the potential pros and cons of a single-payer healthcare system for both physicians and patients—and even the likelihood of our country adopting such a system—Dr. Amy Mackey is joined by a representative from the American Medical Association (AMA): Vice President of Government Affairs Cynthia Brown.

    The New Value-Based Approach to Primary Care, Part 1

    Play Episode Listen Later Jul 19, 2019


    Guest: Alex Azar Recorded live at the American Medical Association’s meeting on the new value-based approach to primary care, Alex Azar and Seema Verma take turns explaining the CMS Primary Cares initiative, which aims to put the focus back on keeping patients healthy as opposed to ordering procedures. As the 24th Secretary of the Department of Health and Human Services, Alex Azar is pursuing four objectives, including lowering prescription drug prices and making individual insurance more affordable, while Seema Verma as the Administrator of the Centers for Medicare and Medicaid Services is working towards improving E/M codes to save providers’ time and money.

    The New Value-Based Approach to Primary Care, Part 2

    Play Episode Listen Later Jul 19, 2019


    Guest: Adam Boehler Guest: Russell Kohl, MD, FAAFP Guest: Kavita Patel, MD, MSHS Recorded live at the American Medical Association’s meeting on the new value-based approach to primary care, Adam Boehler, the Director of the CMS Innovation Center, Dr. Russell Kohl with the American Academy of Family Physicians, and Dr. Kavita Patel, a member of the PTAC, break down the two sets of payment models that comprise the CMS Primary Cares initiative: Primary Care First and Direct Contracting.

    The New Value-Based Approach to Primary Care, Part 1

    Play Episode Listen Later Jul 19, 2019


    Guest: Alex Azar Recorded live at the American Medical Association’s meeting on the new value-based approach to primary care, Alex Azar and Seema Verma take turns explaining the CMS Primary Cares initiative, which aims to put the focus back on keeping patients healthy as opposed to ordering procedures. As the 24th Secretary of the Department of Health and Human Services, Alex Azar is pursuing four objectives, including lowering prescription drug prices and making individual insurance more affordable, while Seema Verma as the Administrator of the Centers for Medicare and Medicaid Services is working towards improving E/M codes to save providers’ time and money.

    The New Value-Based Approach to Primary Care, Part 2

    Play Episode Listen Later Jul 19, 2019


    Guest: Adam Boehler Guest: Russell Kohl, MD, FAAFP Guest: Kavita Patel, MD, MSHS Recorded live at the American Medical Association’s meeting on the new value-based approach to primary care, Adam Boehler, the Director of the CMS Innovation Center, Dr. Russell Kohl with the American Academy of Family Physicians, and Dr. Kavita Patel, a member of the PTAC, break down the two sets of payment models that comprise the CMS Primary Cares initiative: Primary Care First and Direct Contracting.

    Value-Based Care: Taking the Pulse of Key Stakeholders in Healthcare

    Play Episode Listen Later Jun 3, 2019


    Host: Matt Birnholz, MD Guest: Kathleen Blake, MD, MPH Guest: Mandy Cohen, MD, MPH Guest: Sheila Savageau Guest: Michael Seres How do you define value-based care? That’s the question being asked of some of the most influential stakeholders in healthcare, and to find out their answer, Dr. Matt Birnholz sits down with a few of them, including the AMA’s Vice President of Healthcare Quality Dr. Kathleen Blake, General Motors' U.S. Health Leader Sheila Savageau, North Carolina Secretary of Health and Human Services Dr. Mandy Cohen, and Michael Seres, the CEO of 11Health.

    Easing the Burden of Medicare Documentation Guidelines

    Play Episode Listen Later Jan 9, 2019


    Host: Matt Birnholz, MD Guest: Barbara Levy, MD Guest: Peter A. Hollmann, MD In response to physicians’ feedback, the Centers for Medicare and Medicaid Services proposed some big changes to the documentation guidelines for office visits. But is there still room for improvement? Co-chairs of the American Medical Association’s CPT/RUC Workgroup on Evaluation and Management Services Dr. Peter Hollmann and Dr. Barbara Levy join Dr. Matt Birnholz to discuss the Workgroup’s effort to further simplify the work of the healthcare provider and improve the health of patients nationwide.

    Easing the Burden of Medicare Documentation Guidelines

    Play Episode Listen Later Jan 8, 2019


    Host: Matt Birnholz, MD Guest: Barbara Levy, MD Guest: Peter A. Hollmann, MD In response to physicians’ feedback, the Centers for Medicare and Medicaid Services proposed some big changes to the documentation guidelines for office visits. But is there still room for improvement? Co-chairs of the American Medical Association’s CPT/RUC Workgroup on Evaluation and Management Services Dr. Peter Hollmann and Dr. Barbara Levy join Dr. Matt Birnholz to discuss the Workgroup’s effort to further simplify the work of the healthcare provider and improve the health of patients nationwide.

    Easing the Burden of Medicare Documentation Guidelines

    Play Episode Listen Later Jan 8, 2019


    Host: Matt Birnholz, MD Guest: Barbara Levy, MD Guest: Peter A. Hollmann, MD In response to physicians’ feedback, the Centers for Medicare and Medicaid Services proposed some big changes to the documentation guidelines for office visits. But is there still room for improvement? Co-chairs of the American Medical Association’s CPT/RUC Workgroup on Evaluation and Management Services Dr. Peter Hollmann and Dr. Barbara Levy join Dr. Matt Birnholz to discuss the Workgroup’s effort to further simplify the work of the healthcare provider and improve the health of patients nationwide.

    What Do the Updated Medicare Payment Policies Mean for You?

    Play Episode Listen Later Dec 21, 2018


    Host: Matt Birnholz, MD Guest: Barbara A. McAneny, MD There were a lot of changes made to the 2019 Medicare payment policies. Here to review what these updates mean—and what’s being done in response to them—is Dr. Barbara McAneny, President of the AMA.

    What Do the Updated Medicare Payment Policies Mean for You?

    Play Episode Listen Later Dec 20, 2018


    Host: Matt Birnholz, MD Guest: Barbara A. McAneny, MD There were a lot of changes made to the 2019 Medicare payment policies. Here to review what these updates mean—and what’s being done in response to them—is Dr. Barbara McAneny, President of the AMA.

    What Do the Updated Medicare Payment Policies Mean for You?

    Play Episode Listen Later Dec 20, 2018


    Host: Matt Birnholz, MD Guest: Barbara A. McAneny, MD There were a lot of changes made to the 2019 Medicare payment policies. Here to review what these updates mean—and what’s being done in response to them—is Dr. Barbara McAneny, President of the AMA.

    The Future of APMs: What We Learned from the RAND Study

    Play Episode Listen Later Nov 28, 2018


    Host: Jennifer Caudle, DO Guest: Mark Friedberg, MD With the use of alternative payment models (APMs) on the rise, the American Medical Association and the RAND Corporation joined forces to investigate the impact of APMs on physicians across the country. So what exactly did the study uncover? Diving into the study’s findings with Dr. Jennifer Caudle is Dr. Mark Friedberg, senior physician policy researcher at RAND and director of its Boston office.

    The Future of APMs: What We Learned from the RAND Study

    Play Episode Listen Later Nov 27, 2018


    Host: Jennifer Caudle, DO Guest: Mark Friedberg, MD With the use of alternative payment models (APMs) on the rise, the American Medical Association and the RAND Corporation joined forces to investigate the impact of APMs on physicians across the country. So what exactly did the study uncover? Diving into the study’s findings with Dr. Jennifer Caudle is Dr. Mark Friedberg, senior physician policy researcher at RAND and director of its Boston office.

    The Future of APMs: What We Learned from the RAND Study

    Play Episode Listen Later Nov 27, 2018


    Host: Jennifer Caudle, DO Guest: Mark Friedberg, MD With the use of alternative payment models (APMs) on the rise, the American Medical Association and the RAND Corporation joined forces to investigate the impact of APMs on physicians across the country. So what exactly did the study uncover? Diving into the study’s findings with Dr. Jennifer Caudle is Dr. Mark Friedberg, senior physician policy researcher at RAND and director of its Boston office.

    Get the Breakdown on How Costs Are Measured Under MIPS

    Play Episode Listen Later Aug 9, 2018


    Host: Matt Birnholz, MD Guest: Koryn Rubin Some big changes are taking effect in one of the performance categories under MIPS. The cost category is now affecting your MIPS score differently, and here to make sure you don’t fall behind is Koryn Rubin, Assistant Director of Federal Affairs at the American Medical Association.

    Get the Breakdown on How Costs Are Measured Under MIPS

    Play Episode Listen Later Aug 8, 2018


    Host: Matt Birnholz, MD Guest: Koryn Rubin Some big changes are taking effect in one of the performance categories under MIPS. The cost category is now affecting your MIPS score differently, and here to make sure you don’t fall behind is Koryn Rubin, Assistant Director of Federal Affairs at the American Medical Association.

    Get the Breakdown on How Costs Are Measured Under MIPS

    Play Episode Listen Later Aug 8, 2018


    Host: Matt Birnholz, MD Guest: Koryn Rubin Some big changes are taking effect in one of the performance categories under MIPS. The cost category is now affecting your MIPS score differently, and here to make sure you don’t fall behind is Koryn Rubin, Assistant Director of Federal Affairs at the American Medical Association.

    Work in a Hospital? Here’s What You Need to Know About MIPS

    Play Episode Listen Later Jul 26, 2018


    Host: Matt Birnholz, MD Guest: Carol Vargo, MHS Amid all the changes to quality reporting under MIPS, many hospital-based physicians are unsure about what effects, if any, there will be to their employment and compensation. Luckily, there are experts to help break down everything from performance-based changes to compensation accuracy, and providing a how-to guide for navigating the Quality Payment Program in the hospital setting is Carol Vargo, Director of Physician Practice Sustainability at the AMA.

    Work in a Hospital? Here’s What You Need to Know About MIPS

    Play Episode Listen Later Jul 25, 2018


    Host: Matt Birnholz, MD Guest: Carol Vargo, MHS Amid all the changes to quality reporting under MIPS, many hospital-based physicians are unsure about what effects, if any, there will be to their employment and compensation. Luckily, there are experts to help break down everything from performance-based changes to compensation accuracy, and providing a how-to guide for navigating the Quality Payment Program in the hospital setting is Carol Vargo, Director of Physician Practice Sustainability at the AMA.

    Work in a Hospital? Here’s What You Need to Know About MIPS

    Play Episode Listen Later Jul 25, 2018


    Host: Matt Birnholz, MD Guest: Carol Vargo, MHS Amid all the changes to quality reporting under MIPS, many hospital-based physicians are unsure about what effects, if any, there will be to their employment and compensation. Luckily, there are experts to help break down everything from performance-based changes to compensation accuracy, and providing a how-to guide for navigating the Quality Payment Program in the hospital setting is Carol Vargo, Director of Physician Practice Sustainability at the AMA.

    What Is a Virtual Group Under the Quality Payment Program & Should You Join One?

    Play Episode Listen Later Jul 12, 2018


    Host: Matt Birnholz, MD Even though more and more physicians are becoming aware of the option to participate in the Quality Payment Program as a virtual group, many still may not have all the details needed to decide whether this is right for them—or how they can even go about joining one. To help clarify the confusion, Dr. Matt Birnholz is joined by Ashley McGlone, Washington Counsel for the AMA.

    What Is a Virtual Group Under the Quality Payment Program & Should You Join One?

    Play Episode Listen Later Jul 11, 2018


    Host: Matt Birnholz, MD Even though more and more physicians are becoming aware of the option to participate in the Quality Payment Program as a virtual group, many still may not have all the details needed to decide whether this is right for them—or how they can even go about joining one. To help clarify the confusion, Dr. Matt Birnholz is joined by Ashley McGlone, Washington Counsel for the AMA.

    What Is a Virtual Group Under the Quality Payment Program & Should You Join One?

    Play Episode Listen Later Jul 11, 2018


    Host: Matt Birnholz, MD Even though more and more physicians are becoming aware of the option to participate in the Quality Payment Program as a virtual group, many still may not have all the details needed to decide whether this is right for them—or how they can even go about joining one. To help clarify the confusion, Dr. Matt Birnholz is joined by Ashley McGlone, Washington Counsel for the AMA.

    How Physician-Focused APMs Aim to Overcome Challenges

    Play Episode Listen Later Jun 28, 2018


    Host: Matt Birnholz, MD Alternative Payment Models, or APMs, were introduced as a way to reduce costs and improve patient care, but physicians have been slow to adopt this model. To address this issue, Dr. Matt Birnholz connects with Harold Miller, President and CEO of the Center for Healthcare Quality and Payment Reform, who provides the details that physicians need to know regarding APMs and why Physician-Focused Payment Models could be the solution.

    How Physician-Focused APMs Aim to Overcome Challenges

    Play Episode Listen Later Jun 27, 2018


    Host: Matt Birnholz, MD Alternative Payment Models, or APMs, were introduced as a way to reduce costs and improve patient care, but physicians have been slow to adopt this model. To address this issue, Dr. Matt Birnholz connects with Harold Miller, President and CEO of the Center for Healthcare Quality and Payment Reform, who provides the details that physicians need to know regarding APMs and why Physician-Focused Payment Models could be the solution.

    How Physician-Focused APMs Aim to Overcome Challenges

    Play Episode Listen Later Jun 27, 2018


    Host: Matt Birnholz, MD Alternative Payment Models, or APMs, were introduced as a way to reduce costs and improve patient care, but physicians have been slow to adopt this model. To address this issue, Dr. Matt Birnholz connects with Harold Miller, President and CEO of the Center for Healthcare Quality and Payment Reform, who provides the details that physicians need to know regarding APMs and why Physician-Focused Payment Models could be the solution.

    The Quality Payment Program in 2019: What to Know About Upgrading Your EHR

    Play Episode Listen Later Jun 15, 2018


    Host: Shira Johnson, MD Guest: Laura Hoffman Guest: Matt Reid If you’re planning on participating in the Quality Payment Program in 2019, you may be wondering what you can—and should—be doing now to prepare for upgrading your electronic health records, or how this update could affect your computers and networks. If so, you’re not alone. To help guide you through this process, Dr. Shira Johnson is joined by two AMA staff—Senior Health IT Consultant Matt Reid and Assistant Director of Federal Affairs Laura Hoffman—who answer these and other FAQs.

    The Quality Payment Program in 2019: What to Know About Upgrading Your EHR

    Play Episode Listen Later Jun 14, 2018


    Host: Shira Johnson, MD Guest: Laura Hoffman Guest: Matt Reid If you’re planning on participating in the Quality Payment Program in 2019, you may be wondering what you can—and should—be doing now to prepare for upgrading your electronic health records, or how this update could affect your computers and networks. If so, you’re not alone. To help guide you through this process, Dr. Shira Johnson is joined by two AMA staff—Senior Health IT Consultant Matt Reid and Assistant Director of Federal Affairs Laura Hoffman—who answer these and other FAQs.

    The Quality Payment Program in 2019: What to Know About Upgrading Your EHR

    Play Episode Listen Later Jun 14, 2018


    Host: Shira Johnson, MD Guest: Laura Hoffman Guest: Matt Reid If you’re planning on participating in the Quality Payment Program in 2019, you may be wondering what you can—and should—be doing now to prepare for upgrading your electronic health records, or how this update could affect your computers and networks. If so, you’re not alone. To help guide you through this process, Dr. Shira Johnson is joined by two AMA staff—Senior Health IT Consultant Matt Reid and Assistant Director of Federal Affairs Laura Hoffman—who answer these and other FAQs.

    What Are Your Quality Reporting Options?

    Play Episode Listen Later May 31, 2018


    Host: Matt Birnholz, MD Guest: Koryn Rubin With more and more physicians wondering what the new individual and group reporting measures mean for them and their practice, Dr. Matt Birnholz sat down with Koryn Rubin, Assistant Director of Federal Affairs at the American Medical Association, to break down these options.

    What Are Your Quality Reporting Options?

    Play Episode Listen Later May 30, 2018


    Host: Matt Birnholz, MD Guest: Koryn Rubin With more and more physicians wondering what the new individual and group reporting measures mean for them and their practice, Dr. Matt Birnholz sat down with Koryn Rubin, Assistant Director of Federal Affairs at the American Medical Association, to break down these options.

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