Podcasts about quality payment program

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Best podcasts about quality payment program

Latest podcast episodes about quality payment program

Empathy Affect
Season 2, Episode 4: Motherhood + Modernization: USDS is Shaping Equitable Post-Natal Care

Empathy Affect

Play Episode Listen Later Mar 7, 2024 28:53


For many mothers, the immediate postnatal period is a vulnerable one, often filled with financial, social, physical, and mental challenges while caring for a young child. Our federal government is working to provide better resources and services to support women through early motherhood, and U.S. Digital Service (USDS) is stepping up with solutions to make it easier, equitable, and more effective. Our guest, Birth of a Child Portfolio Lead Maya Mechenbier, became a mother shortly before leading these efforts at USDS, grounding the work USDS does for federal agencies with her own journey raising two daughters. Learn how she and her team are helping agencies provide supply kits for mothers, peer navigation resources, and text-based notifications to help mothers apply for federal aid. All of this comes together with technology, UX design, rigorous evaluation, and the personal touch of lived experience.Maya Mechenbier is a project lead and product counsel at USDS and Birth of a Child portfolio lead at the Office of Management and Budget, leading projects including the Peer Navigator Service, Newborn Supply Kit, and Notify for Families. Maya is in her second tour with USDS after serving with USDS's Quality Payment Program team at the Centers for Medicare and Medicaid (CMS) in 2016 and with the Office of Science and Technology Policy (OSTP) at the White House in 2015. She has also served in career roles at the Department of Health and Human Services (HHS) and Federal Communications Commission (FCC).More Links and InformationCheck out more Fors Marsh MediaConnect or partner with Fors MarshRead up on our government's progress supporting mothers through early childhoodGet a deeper dive on the Newborn Supply KitLearn more about USDS's work

Connecting the Dots
Improving how we think about Wound Care with Dr. Caroline Fife

Connecting the Dots

Play Episode Listen Later Feb 29, 2024 36:24


Dr. Fife completed a Family Medicine residency at the University of Texas, Southwestern in Dallas followed by a two-year Fellowship in Undersea and Hyperbaric Medicine at Duke University. Until 2013 she was a Professor of Medicine at the University of Texas Health Science Center, Houston where she initiated the Memorial Hermann Center for Wound Healing and Hyperbaric Medicine and the Lymphedema Center. She is now a Professor of Geriatrics at Baylor College of Medicine in Houston. She serves as the Chief Medical Officer of Intellicure, Inc., a health information technology company, and the Executive Director of the U.S. Wound Registry, a non-profit organization recognized by CMS as a qualified clinical data registry. The USWR develops wound relevant quality measures and helps wound care practitioners meet the requirements of Medicare's Quality Payment Program. Past and present board activities include the Alliance of Wound Care Stakeholders, the American Academy of Wound Management, the Association for the Advancement of Wound Care and the American Professional Wound Care Association. She is the clinical editor of Today's Wound Clinic and has authored more than 100 peer reviewed articles and book chapters as well as editing 3 textbooks (the Textbook of Chronic Wound Care, Wound Care Practice, and Women and Pressure: Diving and Flying.). Her research contributions include the development of real time lymphatic imaging with Dr. Eva Sevick using near infrared technology, and more recently, the use of real-world data for comparative effectiveness studies to understand what works best for patients with chronic wounds and ulcers.Link to claim CME credit: https://www.surveymonkey.com/r/3DXCFW3CME credit is available for up to 3 years after the stated release dateContact CEOD@bmhcc.org if you have any questions about claiming credit.

MedAxiom HeartTalk: Transforming Cardiovascular Care Together

Patients with more advanced disease are returning to hospitals in pre-pandemic volumes and the cost of treating them is now higher. On MedAxiom HeartTalk, host Melanie Lawson speaks with Stuart Jacobson, Founder & CEO of Biome Analytics, Amber Pawlikowski, MSN, RN, CPHQ, Director of Client Services & Quality Improvement Analytics at Biome Analytics, and Bradley Hubbard, MD, Cardiologist at Trinity Health Michigan Heart to discuss the struggles of quality performance improvement during a time of massive resource shortages and some of the major barriers that clinicians face. We're also joined by Joel Sauer, MBA, Executive Vice President, Consulting and Denise Busman, MSN, Vice President, Care Transformation at MedAxiom who share insights on how organizations can use analytics to better achieve the “Quadruple Aim” of healthcare. Guest Bios Bradley Hubbard, MD, Cardiologist, Trinity Health Michigan Heart - Dr. Hubbard has more than 20 years of experience practicing in the area. His clinical interests include cardiac MRI, critical care, and monitoring quality outcomes. Dr. Hubbard also has additional training in adult comprehensive echocardiography and nuclear cardiology. He is the director of the coronary care unit and section head of cardiology at St. Joseph Mercy Ann Arbor, as well as a clinical instructor in internal medicine at the University of Michigan Medical School. Amber Pawlikowski, MSN, RN, CPHQ, Director of Client Services & Quality Improvement Analytics, Biome Analytics - Amber is a passionate and driven healthcare leader with over a decade of experience in healthcare delivery and services. She is considered a young, rising figure and prominent voice in the areas of data analytics and quality improvement methodologies. As a healthcare leader, Amber has created, directed, implemented, and continuously monitored quality strategic plans and outcomes for the nation's largest CVSLs with specific focus on cardiothoracic surgery, vascular surgery, cardiology (medical, interventional and electrophysiology) and interventional radiology. Amber currently serves as Director of Client Services and Quality Improvement Analytics at Biome, a leading provider of performance solutions for enterprise cardiovascular centers  Stuart Jacobson, Founder & CEO, Biome Analytics – An entrepreneur, Stuart Jacobson co-founded Biome Analytics in 2013.  Denise Busman, MSN, VP, Care Transformation at MedAxiom - Denise brings more than 30 years of experience as a cardiovascular clinician and leader to MedAxiom. Her clinical expertise is complemented by a passion for engaging multi-disciplinary teams to transform care delivery and enhance clinical quality. Known for her work in program development and change management, Denise is skilled in the implementation of new programs and clinical initiatives. Denise joins MedAxiom from Spectrum Health, a multi-hospital system in Michigan, where she held a variety of positions including critical care educator and cardiology clinical nurse specialist. Most recently, her focus was directed toward clinical improvement and quality for the cardiovascular service line, where she implemented innovative approaches to care and served as a trusted advisor to cardiovascular physicians and team members. Denise holds a bachelor's degree in nursing from Michigan State University and master's degree in nursing from Grand Valley State University. She has been active with the American College of Cardiology for many years as a Michigan Chapter board member and cardiovascular team liaison, ACC Scientific Program Committee member, and reviewer of scientific abstracts. Joel Sauer, MBA, EVP - Consulting, MedAxiom - Since 2010 Joel Sauer has been providing consultative services around the country to accelerate the value transition in health care, particularly within the cardiovascular realm. A significant area of concentration has been creating contemporary and effective physician/hospital partnership structures, utilizing employment and other contractual arrangements (such as professional services agreements) and joint ventures. His work includes full-service line advancement, including governance and leadership development, and the creation of targeted co-management programs. Joel is an expert in vision and strategy setting, cultural and operational integration, and physician compensation plan design that promotes the vision and objectives of the organization. Prior to consulting, Joel spent 14 years as Chief Executive Officer of a large Midwestern multi-specialty physician group that included 23 cardiologists. In 2008 Joel led his group through acquisition by a major health system and then took over as CEO of its entire physician enterprise, which eventually included nearly 500 providers. A recognized national resource in cardiovascular physician compensation, Joel is author of the annual MedAxiom Provider Compensation & Production Survey and has expertise in provider workforce planning and development.  Along with the entire MedAxiom Consulting team, he is a resource in new federal payment models such as the Quality Payment Program and the Bundled Payments for Care Improvement Advanced (BPCI Advanced), and other episode payment-based arrangements. Joel is often published in health care magazines, blogs and trade journals and is a regular speaker at national health care meetings.  Bonus Links:https://biome.io/

MGMA Podcasts
MGMA Week in Review: Physician Compensation, the Quality Payment Program, and Overcoming Overwork

MGMA Podcasts

Play Episode Listen Later May 29, 2022 5:19


In this episode of the MGMA Week in Review podcast, we feature articles on physician compensation benchmarks, the quality payment program, and resisting the pressure to overwork. Sources in this episode: Physician Compensation Benchmarks-- https://www.mgma.com/data/data-stories/physician-compensation-benchmarks-to-navigate-the The Quality Payment Program -- https://qpp.cms.gov/?utm_source=nl-gov-ed-washington-connection-2022-05-26&utm_medium=email&utm_campaign=government-affairs&mkt_tok=MTQ0LUFNSi02MzkAAAGEnzk1ECh9lnC8JH7r1pE95fEkKYL1vdVemofVfhNNkLGuLurVYSGm5bT-1wKLnKyg9kPp8ewB4u9Eg7s42qfI-EaFKrwv2ofTFqqRNh8ihw Overcoming Overwork -- https://hbr.org/2022/05/resisting-the-pressure-to-overwork?utm_medium=email&utm_source=newsletter_daily&utm_campaign=dailyalert_notactsubs&deliveryName=DM195543 Additional resources: To keep up with the latest healthcare legislation, visit mgma.com/advocacy. If you want to become part of the discussion, join the MGMA STAT panel by texting “stat” to 33550 or visit www.mgma.com/data/data-stories/mgma-stat-overview. Keep up with the latest industry news by subscribing to the MGMA Insights Newsletter at mgma.com/insightsnewsletter. Listen to our podcasts at www.mgma.com/listen. If you have a story you want to share with us, email us at podcasts@mgma.com.

The #HCBiz Show!
Doctors Just Took a Pay Cut - VBP in 2022 with Gail Zahtz - Part 3

The #HCBiz Show!

Play Episode Listen Later Nov 23, 2021 55:13


The Centers for Medicare & Medicaid Services (CMS) released the 2022 Medicare Physician Fee Schedule and Quality Payment Program final rule on November 2, and there are big changes to physician payments. In particular, the Medicare conversion factor, which forms the basis for payments to clinicians, will be lowered by 3.7%. There's nuance in calculating the payments, but you can sum this up as most doctors will take a pay cut in 2022. And since the final rule goes into effect on January 1, 2022, doctors will begin feeling the cuts in Q1 revenue. The rule is specific to Medicare, but there are plans to push similar changes in Medicaid and we all know commercial payers tend to follow CMS' lead. We believe this change will have a ripple effect across the industry. On this episode, I talk with Gail Zahtz, CEO at PropHealth, as part of our ongoing Value-based Payment in 2022 series about what doctors can expect in terms of Medicare FFS payment come January 1, 2022. We discuss this as another example of CMS trying to make Fee-for-Service less “comfy” and expedite the move to value-based payment models. Gail helps us to understand what options exist and we lay out a framework for how to evaluate those options. This is a heavy episode, and there are no clear answers. However, there is a known direction and a viable path forward. We'll try to get you moving in the right direction.   For full show notes and links: https://thehcbiz.com/177-doctors-just-took-a-pay-cut-vbp-in-2022-with-gail-zahtz-part-3/

Urology Coding and Reimbursement Podcast
UCR 059: Why Bother with QPP (Quality Payment Program)?

Urology Coding and Reimbursement Podcast

Play Episode Listen Later Jul 9, 2021 36:18


July 9, 2021Ray, Mark, and Scott try to answer the question "why bother with QPP?".   Mark shares the reasons why the implementation of value-based medicine is important.  In the discussion, they share the 4 main reasons why you should bother with QPP. Read more about QPP at:https://qpp.cms.gov/ Need help with implementing QPP? Mark and his consultants can guide you:Schedule a call today! REGISTRATION OPENUrology Advanced Coding and Reimbursement Seminar - Live In-Person EventsInformation and RegistrationLas Vegas, December 3-4, 2021New Orleans, January 28-29, 2022Join the discussion:Urology Coding and Reimbursement Group - Join for free and ask your questions, and share your wisdom. Click Here to Start Your Free Trial of AUACodingToday.com  

The Dish on Health IT
Going Beyond "Checking the Box" for Policy Adherence

The Dish on Health IT

Play Episode Listen Later Apr 6, 2021 40:20


On this episode of The Dish on Health IT, Alix Goss vice president and senior consultant at Imprado joins our hosts Ken Kleinberg, Pooja Babbrah and Jocelyn Keegan to talk historical policy and standards milestones, how they brought us to where we are today and why it's important for the industry to go above and beyond the mentality of just checking the box for policy adherence in order to gain a competitive advantage and achieve better patient outcomes. Kens asks Alix to give us a breakdown of how we got to where we are today in health IT. Alix kicks off the podcast by explaining that for several decades, we've been trying to address improved affordability and outcomes in our healthcare system. It's about the right data at the right time for the right patient and in the right format. In 1996, under the Health Insurance Portability and Accountability Act, we set off on a journey that forced us to be on a trajectory, as a nation, in our information exchange for administrative simplification. Think of that as governing, or establishing, pharmacy and medical standards along the way, in the 1999 to 2003 timeframe.Then, we rolled up our sleeves and tried to make all of that work only to realize we really needed to bring clinical aspects into it too. We started working on the American Health Information Community (AHIC) under the Bush administration, which helped us figure out what clinical data exchange needed to look like. A lot of the work was memorialized under the Health Information Technology and Economic and Clinical Health Act (HITECH) of 2009. Shortly after, we got the Affordable Care Act. Then came the Medicare Access and CHIP Reauthorization Act of 2015, which established a robust Quality Payment Program, changing the way Medicare rewards for clinical value over volume. Most recently, our journey continued with the 21st Century Cures Act in 2016, which promotes and funds the acceleration of research and drug and medical device development. In the end, HIPAA gave us administration simplification and now 21st Century Cures is bookending decades of progress and forcing us into this intersection of clinical administrative data all around the patient.Ken asks Alix if she believes Fast Healthcare Interoperability Resources (FHIR) application programming interfaces (APIs) and rated standards are innovative. She responds with a question. What is your definition of innovation? If you're in other industries you're probably thinking, yeah, not so much. But for healthcare, we're so complex with the variability of all the data elements. Our current transaction evolution to adopt FHIR will provide us with greater flexibility throughout the entire process. Alix thinks FHIR is the way we're going to bridge a great deal of problems, but she does not necessarily see electronic data interchange (EDI) going away. It's gotten into the DNA of our architectures and our business decisions. It's the way we do things. We like to adopt new standards, but where we always fall short is doing the cultural transformation of workflows as opposed to sometimes just having a “check the box” mentality.Jocelyn, who has extensive FHIR Accelerator experience, notes it is no longer just about the rules or the laws that have gone into effect, it really has to do with if we're not figuring out how to make value-based care work, what is our alternative? What will push people to make the shift? The pandemic further exposed current weaknesses in our ability to exchange clinical data, to let us roll out vaccines at scale across our public health infrastructure. There could not be a more compelling business case for why it's so imperative for everyone to start picking up existing tools and implementing. As data starts to free and more players implement, those that don't react or those that have the “check the box” mentality are going to put themselves in a significant competitive disadvantage in the coming years.Pooja has examined these issues from a patient, CARIN Alliance perspective. She is concerned with how we make it easier for patients to access and share their data. FHIR APIs finally get us to that point where it's easier for patients to download their data. We're getting to the point, thanks to some of the recent technology and standards, where it is easier for patients and consumers to download their information and to do searches on price transparency. Ken moves the conversation to payers. He asks Alix if this stakeholder group is embracing change or just “checking the box”. Alix says it is a very mixed landscape out there as far as opinions and corresponding strategies. There are some who are only going to come along when the axe (aka penalties) comes down. Then there are others who are pushing the envelope and pulling folks along. Alix thinks there is a landscape in the payer community that feels overburdened and has its own compliance fatigue. She believes there is also skepticism around what might change. That skepticism coupled with longer term trust dynamics in the payer-provider community plus the sustainability themes for payers (rapidly changing business models) has caused them to start considering things with different lenses that they've never had to before. Past approaches have trained the industry to wait for regulations and incentives to create movement, meaning there is far more “check the box” mentality than anything. Alix is optimistic though, especially under the FHIR Accelerator community, that there is a group of thought leaders who are leaning in and trying to drive a stronger course forward for us all.Ken asks Jocelyn what her comments are about payers being burdened. She notes it is a fair point and that there a couple of factors at play here. To Alix's point, there's a lot of entrenched operational support and infrastructure in place that's been running to support EDI for a number of years, and there has been minimal effort in doing clinical data exchange with payers. Because of the historical combative relationship between payers and providers, we haven't seen much progression yet. However, with the Da Vinci Project, we get to see daily how those relationships are changing. Payers who leverage modern APIs will transform their organizations, how they work and how they view their relationships with provider partners. They will be the ones who come through the curve faster.Pooja notes we are essentially flipping the entire model payers are operating under today. They're not used to opening up their data to others. It's the same in the PBM space. On the pharmacy side, we're not quite there yet but how do we make it easier for data to be shared? How do we make it easier for patients to access their data?Pooja also brings up that payers are having to meet interoperability, patient access and price transparency rules, which is a lot. She has a feeling payers might default to just “checking the box” because they will all be in a rush to meet what's in place today. The point is though, we need people to be thinking outside of “checking the box”. Where can they focus? What are the specific use cases that they could look to in order to achieve a market advantage? Pooja thinks that's where payers need to be paying attention.Alix comments that we're not just transforming standards, we're transforming culture. How does a patient become informed? We have an educational foundation here of using technology to interpret information in collaboration with someone's payers, providers, benefit plans and their family's budget. That's how we stitch this all together. However, to Pooja's point, the history of payers and the cultural transformation is one of our shortcomings in implementation efforts that we've undertaken in the last 30 years.Ken asks Alix how she sees the new federal administration playing out over the next few years. Alix says public infrastructure has been duct taped together and underfunded for decades. The work people have done at a local and state level in partnership with the Centers for Disease Control and Prevention (CDC) has been amazing. It is also amazing how the commercial sector relies on registry and public health information. So many use the data, yet very few people help support the public health infrastructure. So, Alix thinks we are going to see a lot of transformation in the public health space (for the good). Having a new national coordinator like Micky Tripathi is going to really help leverage implementation efforts and take us to the next round of progress. Additionally, Alix does see FHIR as a key factor in bridging a number of issues out there, but she's not expecting a hard left turn in this next administration.Ken asks Alix for her final thoughts. Alix stresses for people to get educated and involved in standards development, both policy and technology standards. If you can't play at the national level directly, you can always offer your public comment on proposed rulemaking. We all have experiences to share and we all should exercise our voice to strengthen our nation's trajectory and agility to respond to all the amazing technology and medical advances that are yet to come. So if you can't get involved directly, tap into the expertise of the folks at Point-of-Care Partners or Imprado because they can inject that knowledge and add your story to their library of perspectives from which we influence.

Modern Practice Podcast
Update on MACRA Rule 2021 – Part 1

Modern Practice Podcast

Play Episode Listen Later Jan 7, 2021 25:21


For physician and clinician leaders, this episode provides the latest information on regulatory activities, including the final MACRA Rule for 2021, that will impact reimbursement. We will discuss changes to the Quality Payment Program, E&M Codes and the Merit-based Incentive Payment System (MIPS), along with the MIPS Value Pathways (MVPs). This is information crucial to physicians and clinicians. Guest speakers:Valinda Rutledge, MBA, MSNFellowSg2 Madeleine McDowell, MDPrincipal, IntelligenceSg2 Moderator:Tomas Villanueva, DO, MBA, FACPE, SFHMAssociate Vice PresidentClinical ResourcesVizient Show Notes:[01:58] E&M Code changes: background, rationale, details—after years of development[06:56] Virtual health changes[10:38] Expanding scope of practice and team-based care[12:21] The MACRA Rule—details and ramifications[16:16] Uncontrollable circumstances – applying for adjustments[16:45] Merit-based Incentive Payment System (MIPS) update[20:47] MIPS Value Pathways (MVPs) Links | Resources:Program handout from December 9, 2020 Vizient Medical Leadership Series webcast: Click hereLink to December 9 webcast: Click hereCMS website on MACRA and QPP Click here Subscribe Today!Apple PodcastsSpotifyAndroidGoogle PodcastsStitcherRSS Feed 

MGMA Podcasts
Total Cost of Care Faces New Challenges, Opportunities

MGMA Podcasts

Play Episode Listen Later Aug 12, 2020 36:59


In this episode of the MGMA Insights Podcast, we're joined by Doral Jacobsen, MBA, FACMPE, CEO, Prosper Beyond. Doral discusses payer contracting during the pandemic, total cost of care, telehealth, and staffing considerations as a result of COVID-19. You can hear more from Doral and other industry experts at MGMA’s virtual Medical Practice Excellence Conference, where she’ll co-present sessions on “Total Cost of Care 2.0: The Quality Payment Program and Beyond” and “RPM and Telehealth: Strategies to Transform Practices to Virtual Health.” You can register for the event at https://bit.ly/3ahdelB. ​If you like the show, please rate and review it wherever you get your podcasts. If you have topics you'd like us to cover or experts you'd like us to interview, email us at podcasts@mgma.com, or reach out to MGMA Sr. Editor and MGMA Insights podcast host Daniel Williams on Twitter at @MGMADaniel. MGMA Insights is presented by Decklan McGee, Rob Ketcham and Daniel Williams. Thanks to Audi for sponsoring this episode. Visit bit.ly/3kn6hV0 to learn more about the MGMA Audi Incentive Program.

RadioRev
4 - The Power of Lived Experience in Addressing SDoH with Adaeze Enekwechi, PhD, MPP

RadioRev

Play Episode Listen Later Mar 31, 2020 29:44


In this episode, Adaeze Enekwechi, PhD, MPP, President at IMPAQ joins the show to discuss the importance of lived experience when talking about social determinants of health. We discuss government programs and policies that challenge SDoH, innovative solutions that stand out, and where we're headed as an industry. To connect with Adaeze: LinkedIn: https://www.linkedin.com/in/adaeze-enekwechi-phd/ Read Adaeze's article in Health Affairs: "It’s Time To Address the Role of Implicit Bias Within Health Care Delivery.” Dr. Adaeze Enekwechi is the President of IMPAQ, a 400 person policy research and analytics firm that comprises three entities: IMPAQ International, a public policy research and analytics firm; Maher & Maher, a learning solutions provider; and ASCEND, a technology and information product company. Dr. Enekwechi provides strategic oversight of all research, technical assistance, and technology services across all policy and program areas, including health care, workforce development, social programs, and international development. Prior to joining IMPAQ, Dr. Enekwechi served as Vice President for Policy, Strategy, and Analytics with a consulting firm. She also served as the Associate Director for Health Programs at the White House Office of Management and Budget (OMB) under President Obama. As the Federal government's chief health care budget official, she provided policy, management, and regulatory oversight for over $1 trillion in spending on a range of Federal programs, including the Centers for Medicare & Medicaid Services, Centers for Disease Control and Prevention, the National Institutes of Health, and all Federal health agencies. At the OMB, Dr. Enekwechi managed the review and approval of all major Center for Medicare & Medicaid Innovation reform proposals, Medicare Access and CHIP Reauthorization Act of 2015/Quality Payment Program rulemaking, and many Food and Drug Administration policies, Medicaid negotiations, Zika, and other public health funding requests. Dr. Enekwechi is highly experienced with the Affordable Care Act (ACA) implementation, playing a key role in driving ACA budget, policy, strategy, and operational coordination with various agencies, including the Department of Treasury, the Internal Revenue Service, and the Office of Personnel Management, among others. Dr. Enekwechi completed a BA at the University of Iowa, an MPP at the American University, and a PhD in Health Services and Policy from the University of Iowa. Her research area covers social determinants of health, long-term care, and evidence based policymaking. Dr. Enekwechi is a Research Associate Professor of Health Policy and Management at the Milken Institute School of Public Health at the George Washington University and was a Visiting Professor at Meharry Medical College in Nashville, TN. Her teaching focuses on Federal health policy, the US health care infrastructure, health equity, and evidence-based policymaking. She also serves on the boards of directors and advisors for a number of health care organizations.

The PILL Podcast
Episode 7: Dr. Tamea Evans - Fighting for Good Outcomes

The PILL Podcast

Play Episode Listen Later Dec 17, 2019 40:05


In our second episode of the PILL podcast focused on diabetes prevention and treatment, Trudi speaks with Dr. Tamea Evans, a 2003 graduate of the University of Kentucky College of Medicine. Dr Evans is an Internal Medicine physician and diabetologist who is passionate about helping patients with long term illness get the tools and knowledge they need in order to get and stay well. Listen as she shares what it means to be "blessed by bad" and how doctors can be rewarded for doing a good job. This episode includes a focus on diabetes self-management education and support (DSMES), a fundamental but underutilized element of diabetes care. Kentucky has around 95 recognized or accredited DSMES programs and branches serving 88 counties across the Commonwealth. To find locations go to https://prdweb.chfs.ky.gov/KYDiabetesResources/ and search for “Nationally Recognized or Accredited Diabetes Self-Management Education and Support Classes”.  If you need assistance with quality improvement call the Kentucky REC at 859-323-3090 or email us at kyrec@uky.edu. Check out our website at www.kentuckyrec.com. For specific Quality Payment Program assistance, enroll in our online resource center at www.qppresourcecenter.org. Royalty Free Music from Bensound 

ASCO in Action Podcast
How Will Your Practice be Affected by the 2020 Medicare Physician Fee Schedule?

ASCO in Action Podcast

Play Episode Listen Later Dec 10, 2019 6:37


In the latest ASCO in Action Podcast, ASCO CEO Dr. Clifford A. Hudis, discusses updates that will affect oncologists in the 2020 Medicare Physician Fee Schedule final rule, which outlines changes to Part B reimbursement policies and the Quality Payment Program.   ASCO’s goal will always be “to ensure that oncologists can provide the right treatment, at the right time,” says Dr. Hudis, “and we aim to help CMS implement policies that advance that goal.”     Take the ASCO Podcast Survey and help ASCO improve its podcast program: https://www.surveymonkey.com/r/ascopodcasts The purpose of this podcast is to educate and to inform. This is not a substitute for professional medical care and is not intended for use in the diagnosis or treatment of individual conditions. Guests on this podcast express their own opinions, experience, and conclusions. The mention of any product, service, organization, activity, or therapy should not be construed as an ASCO endorsement.   Welcome to the ASCO in Action Podcast, brought to you by the ASCO Podcast Network, a collection of 9 programs covering a range of educational and scientific content and offering enriching insight into the world of cancer care. You can find all of the shows, including this one, at podcast.asco.org. The ASCO in Action Podcast is ASCO’s podcast series that explores the policy and practice issues that impact oncologists, the entire cancer care delivery team, and the individuals we care for—people with cancer. I’m Dr. Clifford Hudis, CEO of ASCO and the host of the ASCO in Action podcast series. For this podcast, I wanted to provide a quick update on an important announcement from the Centers for Medicare & Medicaid Services, which of course we refer to as CMS on this podcast. In early November, the agency released its final rule for the 2020 Medicare Physician Fee Schedule—commonly referred as the “physician fee schedule”—and other changes to Medicare Part B reimbursement policies, including proposed updates to the Quality Payment Program.   Just to review, the physician fee schedule is a complete listing of fees that Medicare uses to pay doctors or other providers and suppliers. It is also a comprehensive listing of maximum fees that is updated each year and used to reimburse providers on a fee-for-service basis. At ASCO, we always review this rule closely and assess its likely impact our members and, most importantly, our patients. The top takeaway from the rule is that CMS estimates a zero percent overall impact for the hematology/oncology and radiation oncology specialties in 2020. Though it’s important to note that the actual impact on individual physician practices will depend on the mix of services the practice provides, and practices in certain states may see a change due to the elimination of the 1.0 threshold previously applied to the geographic practice cost indices. CMS also finalized provisions to align Evaluation & Management (or E&M) coding with changes laid out by the CPT Editorial Panel for office/outpatient E&M visits. This is a welcomed update that comes after ASCO and other stakeholders expressed concerns that earlier CMS proposals to consolidate E&M codes would have diminished the resources available to care for Medicare beneficiaries with cancer. We appreciate the fact that CMS listened to our perspective and revised its plans to better serve people with cancer. The physician fee schedule rule also finalizes updates to the Quality Payment Program for 2020 and beyond. A key update to the Merit-Based Incentive Payment System (or MIPS)—one of the Quality Payment Program’s two tracks—is that all four MIPS performance categories will remain at their 2019 weights in 2020, but the performance threshold, which is the minimum total MIPS score needed to avoid a negative payment adjustment will increase to 45 points in 2020 (up from 30 points in 2019). CMS also finalized its plan to establish “MIPS Value Pathways” (or MVPs) beginning in 2021. CMS has described MVPs as a way to reduce the burden of participating in MIPS and for CMS to collect more meaningful performance data. The MVP framework would connect activities and measures from the four MIPS performance categories that are relevant to a patient population, a medical specialty, or a specific medical condition such as cancer. For years, ASCO has encouraged the use of high-quality oncology clinical pathways to help ensure patient access to high-quality, high-value cancer care. We are hopeful that this provision in the CMS final rule is a move in the right direction. We have also appreciated CMS’ recent efforts to reduce administrative burden for providers. MVPs, if implemented appropriately, may help improve the quality and accessibility of cancer care. We will continue to work closely with CMS as it implements this new provision. I hope this summary of the updates to the physician fee schedule for 2020 was helpful to our listeners. Our ultimate goal is always to ensure that oncologists can provide the right treatment, at the right time, and we aim to help CMS implement policies that advance that goal. To that end we will submit detailed comments on the final rule during the open comment period, to ensure CMS understands the needs of the oncology community, and the full impact this rule is likely to have. If you’d like more information on Medicare physician reimbursement in 2020, please visit the ASCO in Action website at asco.org/ascoaction. Until next time, thank you for listening to this ASCO in Action podcast and if you enjoyed what you heard today, don’t forget to give us a rating or review on Apple Podcasts or wherever you listen and while you are there, be sure to subscribe so you never miss an episode. The ASCO in Action Podcast is just one of ASCO’s many podcasts; you can find all of the shows at podcast.asco.org. If you like what you hear from the ASCO podcast, please let us know. Take our listener survey and help shape the future of the ASCO Podcast Network. Visit podcast.asco.org click on the Survey link. Once again, that's podcast.asco.org. The survey will just take a few minutes to complete and will help us get to know you better. Thank you so much for listening. 

McDermott+Consulting
Health Policy Breakroom Ep. 04: 2020 Changes to the Quality Payment Program

McDermott+Consulting

Play Episode Listen Later Dec 9, 2019 14:47


This episode, Emma is joined by Mara McDermott and Sheila Madhani to discuss 2020 changes to the Quality Payment Program and the landscape of Advanced Alternative Payment Models.

The PILL Podcast
Episode 6: Dr. James Keck - Preventive Medicine

The PILL Podcast

Play Episode Listen Later Nov 20, 2019 37:23


In our new episode of the PILL podcast, Trudi speaks with Dr. James Keck, a Family Medicine and Preventive Medicine board certified physician who cares for patients in the University of Kentucky Family Medicine Clinic. He supervises, trains, and educates medical students and Family and Preventive Medicine Residents at the UK clinic and UK hospital. Recently, Dr. Keck and colleagues implemented several strategies to promote Diabetes Prevention Program referrals from primary care colleagues to the UK Diabetes Prevention Program. He discusses the diagnosis of “prediabetes”, including who should be screened, how it is diagnosed, and next steps to avoid diabetes.  The National Diabetes Prevention Program (National DPP) is a partnership of public and private organizations working to prevent or delay type 2 diabetes. Partners make it easier for people at risk for type 2 diabetes to participate in evidence-based lifestyle change programs to reduce their risk of type 2 diabetes. Kentucky has 55 recognized National Diabetes Prevention Program organizations serving 80 counties with in person classes. We also have online or distance learning locations covering all 120 counties. To find out more go to CHFS.KY.gov and search for Diabetes prevention programs.   If you need assistance with quality improvement call the Kentucky REC at 859-323-3090 or email us at kyrec@uky.edu. Check out our website at www.kentuckyrec.com. For specific Quality Payment Program assistance, enroll in our online resource center at www.qppresourcecenter.org.Royalty Free Music from Bensound 

The Healthcare Policy Podcast ®  Produced by David Introcaso
CMS' Dr. Kate Goodrich Discusses Measuring and Rewarding for Value (or Spending Efficiency) Under Medicare's Forthcoming MVPs Program (November 13th)

The Healthcare Policy Podcast ® Produced by David Introcaso

Play Episode Listen Later Nov 14, 2019 32:37


Listen NowOn November 1st, the Centers for Medicare and Medicaid Services (CMS) published the agency's final 2020 Quality Payment Program (QPP) rule that announced beginning in 2021 CMS will begin instituting MVPs, or Merit-based Incentive Payment System Value Pathways.  These value pathways will be created to financially incent and reward, as CMS states, “high value clinicians.”  This means CMS will begin to measure and financially reward Medicare physician performance based on value or spending efficiency defined as outcomes achieved relative to spending.  MVPs may prove to be a significant Medicare payment policy reform.   This is because while Medicare program officials have implemented numerous "value-based payment" programs and demonstrations since the passage of the 2010 Affordable Care Act, these arrangements financially reward either quality - or - reduced spending growth, they do not reward “value” or spending efficiency.  In addition, as recently noted by Harvard's Ashish Jha and his colleagues in a October 9th JAMA "Viewpoint" essay, these current "value-based payment" programs have not had large effects on quality improvement.   (Listeners may recall I discussed measuring for health care value or spending efficiency with University of Michigan Professor Andrew Ryan this past May 11th and in later May posted on the podcast website a related essay I wrote for Bloomberg Law.)During this 30 minute conversation Dr. Goodrich discusses in sum CMS' proposal to implement beginning in 2021 Merit-based Incentive Payment System Value Pathways (MVPs).  She explains the rationale for using of global and population health measures and patient-reported outcome measures (PROMs) and how the agency will measure or evolve its MVP-related cost measures.  She discusses MVPs potential to increase provider productivity, the potential MVPs have in helping to harmonize Medicare three payment silos: fee for service, Accountable Care Organizations (ACOs); and, the Medicare Advantage (Part C) program, in influencing commercial insurance plans' payment policies through CMS' HCPLAN (the Health Care Payment Learning Action Network), and discusses the relevance or importance of social determinates or measures thereof in driving Medicare value. Dr. Kate Goodrich is currently the Director of the Center for Clinical Standards and Quality (CCSQ) and CMS Chief Medical Officer (CMO).   This Center is responsible for 18 quality measurement and value-based purchasing programs including the Quality Payment Program, quality improvement programs in all 50 states, clinical standards and survey and certification of all providers across the nation, and coverage decisions for treatments and services for CMS.  The Center budget exceeds $1.2 billion annually. Prior to being CCSQ director and CMO, Dr. Goodrich served as the director of the Quality Measurement and Value-based Incentives Group in CCSQ from 2012 through 2015. She graduated from the Robert Wood Johnson Clinical Scholars Program at Yale University in 2010.  From 1998 to 2008, Dr. Goodrich was on the faculty at the George Washington University Medical Center (GWUMC) and served as division director for Hospital Medicine from 2005 to 2008.  She went to medical school at Louisiana State University in Shreveport, Louisiana, and completed her internal medicine residency and chief medical resident year at GWUMC.  She continues to practice clinical medicine as a hospitalist and professor of medicine at GWUMC.The Quality Payment Program final 2020 rule that discusses MVPs is at: https://www.federalregister.gov/documents/2019/11/15/2019-24086/medicare-program-cy-2020-revisions-to-payment-policies-under-the-physician-fee-schedule-and-other. Information on the HCPLAN is at: https://hcp-lan.org/. The Bloomberg Law essay is, again, at: https://news.bloomberglaw.com/health-law-and-business/insight-containing-health-costs-requires-measuring-rewarding-spending-efficiency.  This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit www.thehealthcarepolicypodcast.com

K&L Gates Health Care Triage
K&L Gates Triage: Quality Payment Program Updates in the CY2020 Physician Fee Schedule Proposed Rule - Part 3

K&L Gates Health Care Triage

Play Episode Listen Later Oct 17, 2019 9:39


In this week’s episode, Steve Pine presents the last installment of our three part series addressing the CMS Quality Payment Program (QPP) updates in the CY2020 Physician Fee Schedule (PFS) Proposed Rule. In this episode, Mr. Pine explains a number of Advanced Alternative Payment Models (APM) proposals, including new incentive structures and changes to applicable reporting requirements. Presenters: Steven G. Pine Download Presentation Materials

Audible Bleeding
Caitlin W. Hicks, MD, MS - Overuse of early peripheral vascular interventions in claudication

Audible Bleeding

Play Episode Listen Later Oct 8, 2019 26:59


Dr. Caitlin Hicks is an assistant professor of surgery in the division of vascular and endovascular therapy at Johns Hopkins University in Baltimore, MD.  She is already an accomplished researcher but is also an appointed member of a CMS Clinical Expert Subcommittee tasked with refining peripheral vascular disease cost measures for implementation in the Quality Payment Program. We discuss the fundamentals of claudication management and her recent paper presented at VAM in June 2019, Overuse of early peripheral vascular interventions in claudication. Her work was recently highlighted in the Wall Street Journal in an article entitled Doctors Sound an Alarm Over Leg-Stent Surgery. Support Audible Bleeding Here!

K&L Gates Health Care Triage
K&L Gates Triage: Quality Payment Program Updates in the CY2020 Physician Fee Schedule Proposed Rule - Part 2

K&L Gates Health Care Triage

Play Episode Listen Later Oct 4, 2019 11:35


In this week’s episode, Kathy Barger presents the second in a three part series addressing the CMS Quality Payment Program (QPP) updates in the CY2020 Physician Fee Schedule (PFS) Proposed Rule. In this episode, Ms. Barger discusses several additional key Merit-Based Incentive Payment System (MIPS) proposals presented in the proposed rule, including those related to the weighting of performance categories and updates to MIPS performance thresholds. Presenters: Kathy G. Barger Download Presentation Materials

The PILL Podcast
Episode 5: Hank Kerschen - Accountable Care Organizations

The PILL Podcast

Play Episode Listen Later Oct 3, 2019 56:49


In this episode of the PILL podcast, Trudi interviews Hank Kerschen, a healthcare executive experienced in multi-specialty group practices and integrated delivery systems. He excels in group development, strategic planning, relationship management, and project management. He discusses the process and benefits of joining an Accountable Care Organization (ACO), and the journey of St. Elizabeth to participate in a value-based care model. He also addresses how to navigate being in both of the healthcare reimbursement worlds of fee-for-service and value-based care at the same time.If you need assistance with quality improvement call the Kentucky REC at 859-323-3090 or email us at kyrec@uky.edu. Check out our website at www.kentuckyrec.com. For specific Quality Payment Program assistance, enroll in our online resource center at www.qppresourcecenter.org.Royalty Free Music from Bensound 

K&L Gates Health Care Triage
K&L Gates Triage: Quality Payment Program Updates in the CY2020 Physician Fee Schedule Proposed Rule - Part 1

K&L Gates Health Care Triage

Play Episode Listen Later Sep 26, 2019 7:45


In this week’s episode, Limo Cherian presents the first segment of a three part series addressing the Centers for Medicare & Medicaid Services (CMS) Quality Payment Program (QPP) updates in the CY2020 Physician Fee Schedule (PFS) Proposed Rule.  Ms. Cherian presents an overview of the QPP and discusses CMS’ newly proposed framework for Merit-based Incentive Payment System (MIPS) participation, the MIPS Value Pathways. Presenters: Limo T. Cherian Download Presentation Materials

The PILL Podcast
Episode 1: Karen Ditsch - Reluctant Convert

The PILL Podcast

Play Episode Listen Later Sep 12, 2019 40:36


In the first full-length episode of The PILL Podcast, Karen Ditsch, CEO of Juniper Health in Eastern Kentucky, tells you about her own journey in becoming a quality improvement star. Karen talks about how she started with quality improvement and how it ultimately led to better patient care. She discusses the importance of data-driven decision making and how she used her Electronic Health Record to help achieve improved outcomes, offering some important lessons that you can take back to your organization and implement. If you need assistance with quality improvement, call the Kentucky REC at 859-323-3090 or check out our website at www.kentuckyrec.com. For specific Quality Payment Program assistance, check out our online resource center at www.qppresourcecenter.org.

The PILL Podcast
Episode 2: Dr. Chris Yost - A Physician's Perspective

The PILL Podcast

Play Episode Listen Later Sep 12, 2019 43:48


In this episode of the PILL podcast, we interview Dr. Chris Yost, Medical Director for Ambulatory Quality at UK HealthCare, Assistant Professor in the Department of Internal Medicine, and Co-Chair of the UK HealthCare MACRA steering committee. Dr. Yost brings a unique perspective as he leads the initiatives to improve quality and value in a large academic medical center. He not only plays a key role in UK HealthCare's preparation for value-based payment and quality improvement, but he is also a practicing physician. This makes him better able to handle the key issues of physician buy-in and engagement, which are required for true organizational transformation. He also discusses the journey of leading the charge for Patient-Centered Medical Home recognition and discusses how this designation helps lay a strong foundation for the larger quality improvement infrastructure. If you need assistance with quality improvement call the Kentucky REC at 859-323-3090 or check out our website at www.kentuckyrec.com. For specific Quality Payment Program assistance, check out our online resource center at www.qppresourcecenter.org.

The PILL Podcast
Bonus Episode: QPP Year 3

The PILL Podcast

Play Episode Listen Later Sep 12, 2019 29:41


In this special bonus episode of The PILL Podcast, Trudi Matthews interviews two of Kentucky Regional Extension Center's subject matter experts, Robin Huffman and Kelly Fountain. These two quality experts break down the major changes to Year 3 in the Quality Payment Program. This overview will help our listeners understand the challenges they face under MACRA in 2019.

The PILL Podcast
Episode 4: Dr. Ken Wilson - Quality Leader

The PILL Podcast

Play Episode Listen Later Sep 12, 2019 75:33


In this episode of the PILL podcast, we interview Dr. Ken Wilson, an Executive Consultant for Norton Healthcare in Louisville, KY.  Dr. Wilson has years of experience leading complex implementation efforts. He provides unique insight from a strategic perspective of change in a large health system within a competitive marketplace.He is also a leader in the enterprise-wide adoption of the Patient-Centered Medical Home model at Norton Healthcare. He previously served as the System Vice President for Clinical Effectiveness & Quality. During his years in this position, Dr. Wilson had oversight over Norton's quality program. In his spare time, he travels internationally to help improve medical care. He has traveled to Rwanda, Uganda, Kenya, and other countries. If you need assistance with quality improvement call the Kentucky REC at 859-323-3090 or check out our website at www.kentuckyrec.com. For specific Quality Payment Program assistance, check out our online resource center at www.qppresourcecenter.orgRoyalty Free Music from Bensound 

Telligen SURS: MIPS Memo
2020 Quality Payment Program (QPP) Proposed Rule: General Updates

Telligen SURS: MIPS Memo

Play Episode Listen Later Sep 11, 2019 8:23


This Podcast series highlights essential changes proposed for the Quality Payment Program in the 2020 proposed rule. In this series, we hope to inform you of what you can expect for QPP in 2020. Telligen SURS we help small practices in Iowa, Nebraska, North Dakota, and South Dakota understand and be successful in the Quality Payment Program. The 2020 proposed rule was released on July 29th and contained proposed changes for the physician fee schedule and the Quality Payment Program. We encourage you to listen to the entire 4 part related to the 2020 proposed rule. Part one will cover general updates proposed for 2020 QPP. Part two will cover the key changes proposed for the quality category of QPP. Part three focuses on the changes proposed for the improvement activity and promoting interoperability categories. Part four focuses on the cost category. Thanks for tuning in!

Telligen SURS: MIPS Memo
2020 Quality Payment Program (QPP) Proposed Rule: Quality Category Updates

Telligen SURS: MIPS Memo

Play Episode Listen Later Sep 11, 2019 9:45


This Podcast series highlights essential changes proposed for the Quality Payment Program in the 2020 proposed rule. In this series, we hope to inform you of what you can expect for QPP in 2020. Telligen SURS we help small practices in Iowa, Nebraska, North Dakota, and South Dakota understand and be successful in the Quality Payment Program. The 2020 proposed rule was released on July 29th and contained proposed changes for the physician fee schedule and the Quality Payment Program. We encourage you to listen to the entire 4 part related to the 2020 proposed rule. Part one will cover general updates proposed for 2020 QPP. Part two will cover the key changes proposed for the quality category of QPP. Part three focuses on the changes proposed for the improvement activity and promoting interoperability categories. Part four focuses on the cost category. Thanks for tuning in!

Telligen SURS: MIPS Memo
2020 Quality Payment Program (QPP) Proposed Rule: Improvement Activities & Promoting Interoperability Updates

Telligen SURS: MIPS Memo

Play Episode Listen Later Sep 11, 2019 10:07


This Podcast series highlights essential changes proposed for the Quality Payment Program in the 2020 proposed rule. In this series, we hope to inform you of what you can expect for QPP in 2020. Telligen SURS we help small practices in Iowa, Nebraska, North Dakota, and South Dakota understand and be successful in the Quality Payment Program. The 2020 proposed rule was released on July 29th and contained proposed changes for the physician fee schedule and the Quality Payment Program. We encourage you to listen to the entire 4 part related to the 2020 proposed rule. Part one will cover general updates proposed for 2020 QPP. Part two will cover the key changes proposed for the quality category of QPP. Part three focuses on the changes proposed for the improvement activity and promoting interoperability categories. Part four focuses on the cost category. Thanks for tuning in!

Telligen SURS: MIPS Memo
2020 Quality Payment Program (QPP) Proposed Rule: Cost Category

Telligen SURS: MIPS Memo

Play Episode Listen Later Sep 11, 2019 9:11


This Podcast series highlights essential changes proposed for the Quality Payment Program in the 2020 proposed rule. In this series, we hope to inform you of what you can expect for QPP in 2020. Telligen SURS we help small practices in Iowa, Nebraska, North Dakota, and South Dakota understand and be successful in the Quality Payment Program. The 2020 proposed rule was released on July 29th and contained proposed changes for the physician fee schedule and the Quality Payment Program. We encourage you to listen to the entire 4 part related to the 2020 proposed rule. Part one will cover general updates proposed for 2020 QPP. Part two will cover the key changes proposed for the quality category of QPP. Part three focuses on the changes proposed for the improvement activity and promoting interoperability categories. Part four focuses on the cost category. Thanks for tuning in!

The Inspired Service Podcast
Ep.11: U.S. Digital Service's Shannon Sartin Improving Healthcare for 53M

The Inspired Service Podcast

Play Episode Listen Later Jul 24, 2019 35:13


"We have to actually empower people when they show up." - Shannon Sartin Shannon Sartin didn't graduate high school. She didn't study computer science or engineering in college. So how did she end up as the Executive Director for the U.S. Digital Service at the Department of Health and Human Services?  Ahead of the Blue Button Developer's Conference, we sat down with Shannon to talk about her journey from high school dropout to frontline technologist driving accountability and innovation at the highest levels of America's healthcare system.  Whether you've heard of the Quality Payment Program, or haven't got the faintest clue about how America's Medicare/Medicaid systems work, Shannon's story is a powerful reminder that we can all do more to take our future into our own hands.

National Rural Health Resource Center's Podcasts
Physician Engagement for Value-Based Care Success and Quality Payment Program Update

National Rural Health Resource Center's Podcasts

Play Episode Listen Later Apr 26, 2019 56:18


The transition from volume-based payment to value-based payment is underway – accountable care organizations, bundled payment plans, and global budgets are coming to rural hospitals. With value-based payment comes an expectation for care-improving and cost-saving performance. Value-based performance will be driven by, and evaluated on, physician performance. Therefore, to be successful in value-based payment strategies, rural hospitals must actively engage and collaborate with local physicians. Rural hospitals that proactively engage physicians in the transitions to new payment and care models will be most capable of receiving value-based payment. Dr. MacKinney will discuss new value-based care and payment models that are increasingly prevalent, even in rural areas. He will discuss the stereotypical differences between physicians and administrators and how an understanding of those differences can increase the likelihood of trusting relationships and shared visions. Lastly, Dr. MacKinney will discuss recent updates to the Quality Payment Program. Objectives ·         Understand the increasingly important role physicians play in value-based care and payment ·         Describe the stereotypical differences between administrators and physicians ·         Discuss administrative strategies likely to improve physician engagement ·         Understand new Quality Payment Program updates

Speaking Out on QPP
A Closer Look at the Cost Performance Category

Speaking Out on QPP

Play Episode Listen Later Apr 10, 2019 14:23


Speaking Out on The Quality Payment Program’s fourth episode explores the cost category as a part of the Merit-based Incentive Payment System otherwise known as (MIPS). The Cost category is an important part of the Merit-based Incentive Payment System (MIPS) because it measures resources clinicians use to care for patients and Medicare payments made for care (items and services) provided to beneficiaries. Our Host, Temaka Wiliams and featured guest, MGMA Consultant Pamela Ballou-Nelson, RN, MSPH, CMPE, PhD discuss what should be reported and how measures are scored.Be sure to join us in the future as we continue to speak out on the complex inner workings of the Quality Payment Program and provide guidance on how to navigate it efficiently. New Episodes are available on the second Wednesday of each month. For more information about the Quality Payment Program, you can visit Telligen’s Quality Payment Program (QPP) Page & Resources. You can also stay up to date on health-related news, workshops and webinars by following Telligen QIN on Facebook, Twitter and LinkedIn.

Speaking Out on The Quality Payment Program (QPP)
A Closer Look at the Cost Performance Category

Speaking Out on The Quality Payment Program (QPP)

Play Episode Listen Later Apr 10, 2019 14:22


Speaking Out on The Quality Payment Program’s fourth episode explores the cost category as a part of the Merit-based Incentive Payment System otherwise known as (MIPS). The Cost category is an important part of the Merit-based Incentive Payment System (MIPS) because it measures resources clinicians use to care for patients and Medicare payments made for care (items and services) provided to beneficiaries. Our Host, Temaka Wiliams and featured guest, MGMA Consultant Pamela Ballou-Nelson, RN, MSPH, CMPE, PhD discuss what should be reported and how measures are scored. Be sure to join us in the future as we continue to speak out on the complex inner workings of the Quality Payment Program and provide guidance on how to navigate it efficiently. New Episodes are available on the second Wednesday of each month. For more information about the Quality Payment Program, you can visit Telligen’s Quality Payment Program (QPP) Page & Resources. You can also stay up to date on health-related news, workshops and webinars by following Telligen QIN on Facebook, Twitter and LinkedIn. Listen on Mobile: Apple Podcasts, Google Play, Anchor and Spotify

Speaking Out on Pain Management
A Closer Look at the Cost Performance Category

Speaking Out on Pain Management

Play Episode Listen Later Apr 10, 2019 14:22


Speaking Out on The Quality Payment Program’s fourth episode explores the cost category as a part of the Merit-based Incentive Payment System otherwise known as (MIPS). The Cost category is an important part of the Merit-based Incentive Payment System (MIPS) because it measures resources clinicians use to care for patients and Medicare payments made for care (items and services) provided to beneficiaries.

Speaking Out on QPP
MIPS: The Expansion of New Eligible Clinician Types and What You Need to Know

Speaking Out on QPP

Play Episode Listen Later Mar 15, 2019 16:23


Starting this year the definition of the Merit-Based Incentive Payment System (MIPS) eligible clinicians was expanded to include additional clinician types such as clinical psychologists, physical therapists, speech language pathologists and more.In this third episode of the Speaking Out on the Quality Payment Program Podcast our Host, Temaka Williams and featured guests, Michelle Brunsen and Kelly Smith give an overview on who the newly expanded qualifying MIPS eligible clinician types are and what they need to do to prepare for 2019 MIPS reporting.Be sure to join us in the future as we continue to speak out on the complex inner workings of the Quality Payment Program and provide guidance on how to navigate it efficiently.New Episodes are available on the second Wednesday of each month. For more information about the Quality Payment Program, you can visit Telligen’s Quality Payment Program (QPP) Page & Resources.You can also stay up to date on health-related news, workshops and webinars by following Telligen QIN on Facebook, Twitter and LinkedIn.

Try Not To Blink
Save Your Vision

Try Not To Blink

Play Episode Listen Later Mar 4, 2019 40:47


For a fact sheet on the CY 2019 Physician Fee Schedule proposed rule, please visit: https://www.cms.gov/Newsroom/MediaReleaseDatabase/Fact-sheets/2018-Fact-sheets-items/2018-07-12-2.htmlTo view the CY 2019 Physician Fee Schedule proposed rule, please visit: https://s3.amazonaws.com/public-inspection.federalregister.gov/2018-14985.pdf For a fact sheet on the CY 2019 Quality Payment Program proposed rule, please visit: https://www.cms.gov/Medicare/Quality-Payment-Program/Resource-Library/2019-QPP-proposed-rule-fact-sheet.pdfTo view the CY 2019 Quality Payment Program proposed rule, please visit: https://s3.amazonaws.com/public-inspection.federalregister.gov/2018-14985.pdfFor a fact sheet on the Medicare Advantage Qualifying Payment Arrangement Incentive (MAQI) Demonstration, please visit: https://www.cms.gov/Newsroom/MediaReleaseDatabase/Fact-sheets/2018-Fact-sheets-items/2018-07-12.html

Speaking Out on Pain Management
The Who, What and Why of MIPS Registry Reporting

Speaking Out on Pain Management

Play Episode Listen Later Feb 13, 2019 18:23


Speaking Out on The Quality Payment Program’s second episode discusses Merit-based Incentive Payment System (MIPS) reporting tips for using a registry. Our Host, Temaka Wiliams and featured guest, Dr.Paulo Andre,  CEO and founder of MDinteractive a top-rated Qualified Registry to report MIPS data to CMS,  give a concise discussion on several topic areas that providers should be aware of such as … Continue reading "The Who, What and Why of MIPS Registry Reporting"

Speaking Out on The Quality Payment Program (QPP)
The Who, What and Why of MIPS Registry Reporting

Speaking Out on The Quality Payment Program (QPP)

Play Episode Listen Later Feb 13, 2019 18:22


Speaking Out on The Quality Payment Program’s second episode discusses Merit-based Incentive Payment System (MIPS) reporting tips for using a registry. Our Host, Temaka Wiliams and featured guest, Dr.Paulo Andre, CEO and founder of MDinteractive a top-rated Qualified Registry to report MIPS data to CMS, give a concise discussion on several topic areas that providers should be aware of such as eligibility, submission, important deadlines and more. Be sure to join us in the future as we continue to speak out on the complex inner workings of the Quality Payment Program and provide guidance on how to navigate it efficiently. New Episodes are available on the second Wednesday of each month. For more information about the Quality Payment Program, you can visit Telligen’s Quality Payment Program (QPP) Page & Resources. You can also stay up to date on health-related news, workshops and webinars by following Telligen QIN on Facebook, Twitter and LinkedIn.

Speaking Out on QPP
The Who, What and Why of MIPS Registry Reporting

Speaking Out on QPP

Play Episode Listen Later Feb 13, 2019 18:23


Speaking Out on The Quality Payment Program’s second episode discusses Merit-based Incentive Payment System (MIPS) reporting tips for using a registry. Our Host, Temaka Wiliams and featured guest, Dr.Paulo Andre, CEO and founder of MDinteractive a top-rated Qualified Registry to report MIPS data to CMS, give a concise discussion on several topic areas that providers should be aware of such as eligibility, submission, important deadlines and more.Be sure to join us in the future as we continue to speak out on the complex inner workings of the Quality Payment Program and provide guidance on how to navigate it efficiently. New Episodes are available on the second Wednesday of each month. For more information about the Quality Payment Program, you can visit Telligen’s Quality Payment Program (QPP) Page & Resources. You can also stay up to date on health-related news, workshops and webinars by following Telligen QIN on Facebook, Twitter and LinkedIn.

Speaking Out on QPP
Preparing to Submit 2018 MIPS Data for Clinicians

Speaking Out on QPP

Play Episode Listen Later Jan 18, 2019 14:29


The first episode of The Speaking Out on The Quality Payment Program podcast series will explore best practices for submission of data for the Merit-based Incentive Payment System otherwise known as (MIPS). Our Host, Temaka Wiliams and featured guest, Sandy Swallow give a concise discussion on several topic areas that Clinicians should be aware of as they prepare for their 2018 MIPS Data Submission.Be sure to join us in the future as we continue to speak out on the complex inner workings of the Quality Payment Program and provide guidance on how to navigate it efficiently. New Episodes are available on the second Wednesday of each month. For more information about the Quality Payment Program, you can visit Telligen’s Quality Payment Program (QPP) Page & Resources. You can also stay up to date on health-related news, workshops and webinars by following Telligen QIN on Facebook, Twitter and LinkedIn.

Speaking Out on The Quality Payment Program (QPP)
Preparing To Submit 2018 MIPS Data for Clinicians

Speaking Out on The Quality Payment Program (QPP)

Play Episode Listen Later Jan 15, 2019 14:28


The first episode of The Speaking Out on QPP series takes a serious deep dive into the intricacies of the Merit-based Incentive Payment System otherwise known as (MIPS). Our Host, Temaka Wiliams and featured guest, Sandy Swallow give a concise delivery on several topic areas that Clinicians should be aware of as they prepare for their 2018 MIPS Data Submission. Tune in for helpful bits on: New eligible clinicians Advanced Alternative Payment Models (APM) scoring What makes up the cost category How QPP affects the healthcare delivery system and clinicians Be sure to join us in the future as we continue to speak out on the complex inner workings of the Quality Payment Program and provide guidance on how to navigate it efficiently. New Episodes are available on the second Wednesday of each month until April. For more information about the Quality Payment Program, you can visit Telligen’s Quality Payment Page (QPP) & Resources. You can also stay up to date on health-related news, workshops and webinars by following Telligen QIN on Facebook, Twitter and LinkedIn.

ASCO in Action Podcast
What You Need to Know About the Final 2019 Medicare Physician Fee Schedule and Quality Payment Program Rule

ASCO in Action Podcast

Play Episode Listen Later Jan 8, 2019 8:25


Subscribe through iTunes and Google Play. Welcome to this ASCO in Action podcast. This is ASCO's podcast series where we explore policy and practice issues that have an impact on oncologists, the entire cancer care delivery team, and most importantly, the individuals we care for-- people with cancer. My name is Clifford Hudis, and I'm the CEO of ASCO, as well as the host of the ASCO in Action podcast series. For today's podcast, I'm going to give our listeners a quick update on an important announcement from the Centers for Medicare and Medicaid Services. In an August podcast, I outlined the proposed Medicare Physician Fee Schedule and the Quality Payment Program Rule for 2019. This is commonly referred to as the Physician Fee Schedule. Today, I'm going to provide an update on where we are with this for next year. I have to say in passing, it's probably a good day for me not to have a guest, because I'm here with a terrible cold. So what is the 2019 Medicare Physician Fee Schedule? This is a fee schedule which consists of a complete listing of all of the fees that Medicare uses to pay doctors or other providers and suppliers. It's a comprehensive listing of the maximum fees. And it's updated each year and then used to provide reimbursement to physicians and other providers working on a fee-for-service basis. Now at ASCO, we, every year, review this rule very closely. And we try to determine and predict the impact that it will have on our members, and of course, on our patients. There are three provisions in particular that we want to highlight today. The first of these is related to care provided in calendar year 2019. And CMS estimates that there will be, overall, a 1% reimbursement cut for hematology and oncology, as well as radiation oncology specialties. It is important to note, however, that the actual impact on any individual physician or physician practice will depend on their mix of services-- that is, what it is they exactly provide and bill. Now the administration has publicly stated its aim to reduce the growing administrative burden that we've all been noting and complaining about for the last few years. And the second item we want to point out is there is some evidence of their sensitivity to this issue in the 2019 fee schedule. They intend to reduce the documentation required for evaluation and management services, frequently referred to as E/M. What CMS did is finalize provisions that consolidate E/M payments. And ASCO had expressed concerns about this previously, which the agency acknowledged, along with other stakeholders, by revising the proposal. And, if fully implemented, they believe that the impact will be delayed-- that is, it will not impact providers until 2021. But by that time, CMS plans to consolidate what has historically been Levels 2, 3, and 4 into a single billing level, and then to pay for Level 5 E/M services separately. So overall, this represents a simplification. And it fulfills one of their stated aims, again, of reducing some of the administrative burden that practitioners face. Finally, the third area that I want to highlight is a new rule starting in 2019 that refers to the amount of reimbursement you will receive for new Medicare Part B drugs. Currently, those drugs in Part B are reimbursed at wholesale acquisition cost plus 6%. They will, going forward, be reimbursed at wholesale acquisition cost plus 3%. It's critically important to emphasize that this relates only to those new drugs that are introduced into the supply chain this year. This new provision will also apply to drugs that have not yet reported an average sales price. But the point is it will not apply to drugs that have already been in use. So it only applies to new drugs, meaning that its reach is going to be relatively limited. However, what you can imagine going forward with each new year and new drugs being introduced is that the percentage over wholesale acquisition cost will translate into more and more absolute dollars. And therefore, this may be a growing concern for practices. I want to switch our attention and talk about the Quality Payment Program, or QPP. In the final rule, there is an update to QPP for 2019. The final 2019 payment adjustment for Merit-based Incentive Payment System, or MIPS, practices and providers will become plus or minus 7%. And it will have adjustments to maintain budget neutrality, as well as to reward exceptional performance. Other noteworthy changes will include an increase in the MIPS performance threshold from 15 points, which is where we were in 2018, up to 30 points for 2019. CMS also finalized two new optional opioid-related measures that MIPS providers can use to report on under the Promoting Interoperability category. These measures will give providers an opportunity to earn bonus points and therefore potentially boost their overall MIPS score. These are the two measures specifically. One allows for checking a prescription drug monitoring program, or PDMP, prior to submitting an electronic opioid prescription for any individual patient. And the second is an attempt to verify an existing opioid treatment agreement with the patient receiving the prescription. So I hope that this summary of the updates to the Physician Fee Schedule for 2019 is helpful to our listeners. Ultimately, our goal is to make sure that oncologists can provide the right treatment to the right patient at the right time. And we aim to help CMS implement policies that will advance that goal. ASCO will continue to work closely with the administration to ensure that CMS understands the needs of the oncology community and the full impact that the rule is likely to have. I would encourage you, if you need more information on the Medicare Physician Reimbursement Plan for 2019, to visit ASCO in Action's website. That's at ASCO.org/ASCOaction. And ASCOaction is written as one word. We have a link to the final rule there. And we also have a helpful, I think, webinar that explains the final rule schedule and QPP rule in greater detail. So hoping this is helpful. Until next time, I want to thank you all for listening to this ASCO in Action podcast and hope you don't catch my cold.

Putting Possibility into Practice
Episode 26 - D.C. and You

Putting Possibility into Practice

Play Episode Listen Later Aug 27, 2018 14:31


David Heller, Corporate Counsel, Regulatory Affairs, discusses the latest regulatory happenings impacting providers. He discusses what questions were on customers' minds at ENGAGE18, MIPS assessment scores, and the proposed changes to the Quality Payment Program for 2019. Plus, as an avid college football fan, David offers his pick for the college football season.

ASCO in Action Podcast
ASCO CEO Addresses Concerns with 2019 Medicare Physician Fee Schedule and Quality Payment Program Proposed Rule

ASCO in Action Podcast

Play Episode Listen Later Aug 7, 2018 7:47


In the latest ASCO in Action Podcast, ASCO CEO Dr. Clifford A. Hudis discusses the recently released Medicare Physician Fee Schedule (MPFS) proposed rule. The MPFS is a complete listing of all fees Medicare uses to reimburse doctors and other providers and suppliers under a fee-for-service payment system.

Inside Medicare's New Payment System
Work in a Hospital? Here’s What You Need to Know About MIPS

Inside Medicare's New Payment System

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.

Perspectives with the AMA
Work in a Hospital? Here's What You Need to Know About MIPS

Perspectives with the AMA

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.

Inside Medicare's New Payment System
Work in a Hospital? Here’s What You Need to Know About MIPS

Inside Medicare's New Payment System

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.

Inside Medicare's New Payment System
Work in a Hospital? Here’s What You Need to Know About MIPS

Inside Medicare's New Payment System

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.

Inside Medicare's New Payment System
What Is a Virtual Group Under the Quality Payment Program & Should You Join One?

Inside Medicare's New Payment System

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.

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

Perspectives with the AMA

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.

Inside Medicare's New Payment System
What Is a Virtual Group Under the Quality Payment Program & Should You Join One?

Inside Medicare's New Payment System

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.

Inside Medicare's New Payment System
What Is a Virtual Group Under the Quality Payment Program & Should You Join One?

Inside Medicare's New Payment System

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.

CAPcast
MACRAscopic Analysis: What Pathologists Need to Know about CMS's New Quality Payment Program

CAPcast

Play Episode Listen Later Jul 5, 2018 10:41


In this CAPcast, Dr. Diana Cardona discusses what pathologists need to know about the Medicare Access and CHIP Reauthorization Act of 2015, also known as MACRA. Dr. Cardona, the Medical Director of the Surgical Pathology and Immunopathology Laboratories at Duke University Medical Center, is teaching a course on this topic with Dr. Stephen Black-Schaffer at CAP18 in Chicago, which will be held Oct. 20-24: www.capannualmeeting.org.

Perspectives with the AMA
The Quality Payment Program in 2019: What to Know About Upgrading Your EHR

Perspectives with the AMA

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.

Inside Medicare's New Payment System
The Quality Payment Program in 2019: What to Know About Upgrading Your EHR

Inside Medicare's New Payment System

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.

Inside Medicare's New Payment System
The Quality Payment Program in 2019: What to Know About Upgrading Your EHR

Inside Medicare's New Payment System

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.

Inside Medicare's New Payment System
The Quality Payment Program in 2019: What to Know About Upgrading Your EHR

Inside Medicare's New Payment System

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.

Ask the CIO
U.S. Digital Service helps CMS with ‘novel’ approach to IT modernization

Ask the CIO

Play Episode Listen Later May 9, 2018 43:10


Jonathan Sullivan, a digital services expert at the U.S. Digital Service, said modernizing the Quality Payment Program for CMS required a change in approach.

Lifelong Learning
What the New CMS MACRA Definition Means for QI-CME

Lifelong Learning

Play Episode Listen Later Apr 17, 2018


Host: Alicia A. Sutton Guest: Andrew Rosenberg, JD, MP Guest: Thomas Sullivan Join in as Andrew Rosenberg, JD, MP, Senior Advisor of CME Coalition and Thomas Sullivan, President, and Founder of Rockpointe, discuss how CE providers will be able to offer a PI-QI improvement activity under the Medicare Access and CHIP Reauthorization Act (MACRA). They will also address the MACRA law’s physician incentives for quality care under Medicare, a breakdown of the Quality Payment Program and CE Opportunities, the newly adopted QI CME Improvement Activity, and more!

Neurology® Podcast
March 27 2018 Issue

Neurology® Podcast

Play Episode Listen Later Mar 26, 2018 22:29


1. Featured Article: IgLON5 antibody: Neurological Accompaniments & Outcomes in 20 patients2. What’s Trending: Health policy update - Coding, Reimbursement & Quality Payment ProgramThis Neurology® Podcast begins and closes with Dr. Robert Gross, Editor-in-Chief, briefly discussing highlighted articles from the March 27, 2018, print issue of Neurology. In the first segment, Dr. Stacey Clardy talks with Dr. Andrew McKeon about his Neurology: Neuroimmunology & Neuroinflammation paper describing IgLON5 autoimmunity. For the “What’s Trending” segment, Dr. Jason Crowell speaks with Luana Ciccarelli and Amanda Napoles on regulatory updates in coding and reimbursement, MACRA, and tips for private practitioners on participating in the Quality Payment Program.DISCLOSURES: Dr. Clardy has received research support from Western Institute for Biomedical Research (WIBR).Dr. McKeon has patent applications pending for GFAP and MAP1B as markers of neurological autoimmunity and paraneoplastic disorders; has consulted for Grifols, Medimmune, Inc., and Euroimmun (but did not receive personal compensation for these activities); and has received research support from Medimmune, Inc. and Euroimmun. Dr. Crowell reports no disclosures. Luana Ciccarelli and Amanda Napoles are employed by the American Academy of Neurology.

American College of Osteopathic Family Physicians
Quality Payment Program - Overview 2018 (QPP Part 1)

American College of Osteopathic Family Physicians

Play Episode Listen Later Feb 21, 2018 3:59


The first in the series of Quality Payment Program (QPP) podcast episodes explains what is new for 2018. It also provides a brief overview of the four categories that determine your performance score – and your incentive or penalty adjustment – Quality, Resource Use, Advancing Care Information and Clinical Practice Improvement Activities. Future podcasts will present a deeper dive into understanding each category of the QPP individually. Presented by: Debbie Sarason, ACOFP Manager of Practice Enhancement and Quality Reporting

Perspectives with the AMA
The Technical Assistance You'll Need for the Quality Payment Programs Changes

Perspectives with the AMA

Play Episode Listen Later Feb 2, 2018


Host: Matt Birnholz, MD New rules issued by the Centers for Medicare and Medicaid Services are providing physicians with a smoother transition to the Quality Payment Program, or QPP. One critical part of this support involves technical assistance programs, which provide information and resources to physicians during and after this transition. Host Dr. Matt Birnholz talks with Dr. Edward Sobel and Ms. Temaka Williams about what technical assistance is available to physicians navigating the quality payment program. Dr. Sobel is the Medical Director at Quality Insights,which is based in Charleston, WV, while Miss Williams is a Health Information Technology Advisor at Telligen Oak Brook, Illinois.

Inside Medicare's New Payment System
The Technical Assistance You’ll Need for the Quality Payment Programs Changes

Inside Medicare's New Payment System

Play Episode Listen Later Feb 2, 2018


Host: Matt Birnholz, MD New rules issued by the Centers for Medicare and Medicaid Services are providing physicians with a smoother transition to the Quality Payment Program, or QPP. One critical part of this support involves technical assistance programs, which provide information and resources to physicians during and after this transition. Host Dr. Matt Birnholz talks with Dr. Edward Sobel and Ms. Temaka Williams about what technical assistance is available to physicians navigating the quality payment program. Dr. Sobel is the Medical Director at Quality Insights,which is based in Charleston, WV, while Miss Williams is a Health Information Technology Advisor at Telligen Oak Brook, Illinois.

Inside Medicare's New Payment System
The Technical Assistance You’ll Need for the Quality Payment Programs Changes

Inside Medicare's New Payment System

Play Episode Listen Later Feb 1, 2018


Host: Matt Birnholz, MD New rules issued by the Centers for Medicare and Medicaid Services are providing physicians with a smoother transition to the Quality Payment Program, or QPP. One critical part of this support involves technical assistance programs, which provide information and resources to physicians during and after this transition. Host Dr. Matt Birnholz talks with Dr. Edward Sobel and Ms. Temaka Williams about what technical assistance is available to physicians navigating the quality payment program. Dr. Sobel is the Medical Director at Quality Insights,which is based in Charleston, WV, while Miss Williams is a Health Information Technology Advisor at Telligen Oak Brook, Illinois.

Inside Medicare's New Payment System
The Technical Assistance You’ll Need for the Quality Payment Programs Changes

Inside Medicare's New Payment System

Play Episode Listen Later Feb 1, 2018


Host: Matt Birnholz, MD New rules issued by the Centers for Medicare and Medicaid Services are providing physicians with a smoother transition to the Quality Payment Program, or QPP. One critical part of this support involves technical assistance programs, which provide information and resources to physicians during and after this transition. Host Dr. Matt Birnholz talks with Dr. Edward Sobel and Ms. Temaka Williams about what technical assistance is available to physicians navigating the quality payment program. Dr. Sobel is the Medical Director at Quality Insights,which is based in Charleston, WV, while Miss Williams is a Health Information Technology Advisor at Telligen Oak Brook, Illinois.

AANEM Presents Nerve and Muscle Junction
The Value Transformation of Health Care: Impact on Neuromuscular and Electrodiagnostic Medicine

AANEM Presents Nerve and Muscle Junction

Play Episode Listen Later Jan 25, 2018 28:50


Dr. Scott Speelziek interviews Dr. Pushpa Narayanaswami and Dr. Lyell K Jones about the article, The Value Transformation of Heath Care: Impact on Neuromuscular and Electrodiagnostic Medicine. Beginning in 2017, most physicians who participate in Medicare are subject to the Medicare Access and CHIP Reauthorization Act (MACRA), the milestone legislation that signals the US health care system's transition from volume-based to value-based care. Here we review emerging trends in development of value-based healthcare systems in the US. MACRA and the resulting Quality Payment Program create 2 participation pathways, the Merit-based Incentive Payment System (MIPS) and the Advanced Alternative Payment Model (AAPM) pathway. Although there are several program incentives for AAPM participation, to date there have been few AAPM options for specialists. MIPS and its widening bonus and penalty window will likely be the primary participation pathway in the early years of the program. Value-based payment has the potential to reshape health care delivery in the United States, with implications for neuromuscular and electrodiagnostic (EDX) specialists. Meaningful quality measures are required for neuromuscular and EDX specialists. Muscle Nerve 56: 679-683, 2017.

AANEM Presents Nerve and Muscle Junction
The Value Transformation of Health Care: Impact on Neuromuscular and Electrodiagnostic Medicine.

AANEM Presents Nerve and Muscle Junction

Play Episode Listen Later Jan 19, 2018 28:50


Dr. Scott Speelziek interviews Dr. Pushpa Narayanaswami and Dr. Lyell K Jones about the article, The Value Transformation of Heath Care: Impact on Neuromuscular and Electrodiagnostic Medicine. Beginning in 2017, most physicians who participate in Medicare are subject to the Medicare Access and CHIP Reauthorization Act (MACRA), the milestone legislation that signals the US health care system's transition from volume-based to value-based care. Here we review emerging trends in development of value-based healthcare systems in the US. MACRA and the resulting Quality Payment Program create 2 participation pathways, the Merit-based Incentive Payment System (MIPS) and the Advanced Alternative Payment Model (AAPM) pathway. Although there are several program incentives for AAPM participation, to date there have been few AAPM options for specialists. MIPS and its widening bonus and penalty window will likely be the primary participation pathway in the early years of the program. Value-based payment has the potential to reshape health care delivery in the United States, with implications for neuromuscular and electrodiagnostic (EDX) specialists. Meaningful quality measures are required for neuromuscular and EDX specialists. Muscle Nerve 56: 679-683, 2017.

AANEM Presents Nerve and Muscle Junction
The Value Transformation of Health Care: Impact on Neuromuscular and Electrodiagnostic Medicine.

AANEM Presents Nerve and Muscle Junction

Play Episode Listen Later Jan 19, 2018 28:50


Dr. Scott Speelziek interviews Dr. Pushpa Narayanaswami and Dr. Lyell K Jones about the article, The Value Transformation of Heath Care: Impact on Neuromuscular and Electrodiagnostic Medicine. Beginning in 2017, most physicians who participate in Medicare are subject to the Medicare Access and CHIP Reauthorization Act (MACRA), the milestone legislation that signals the US health care system's transition from volume-based to value-based care. Here we review emerging trends in development of value-based healthcare systems in the US. MACRA and the resulting Quality Payment Program create 2 participation pathways, the Merit-based Incentive Payment System (MIPS) and the Advanced Alternative Payment Model (AAPM) pathway. Although there are several program incentives for AAPM participation, to date there have been few AAPM options for specialists. MIPS and its widening bonus and penalty window will likely be the primary participation pathway in the early years of the program. Value-based payment has the potential to reshape health care delivery in the United States, with implications for neuromuscular and electrodiagnostic (EDX) specialists. Meaningful quality measures are required for neuromuscular and EDX specialists. Muscle Nerve 56: 679-683, 2017.

1st Talk Compliance
MACRA,MIPS and APMs- The New Era of Medicine

1st Talk Compliance

Play Episode Listen Later Nov 30, 2017 62:05


First Healthcare Compliance hosts Tina Colangelo, CEO of Colangelo Consulting, for an interactive discussion on “MACRA,MIPS and APMs- The New Era of Medicine”. This webinar will give attendees everything they need to know about MACRA's Quality Payment Program all in one place! It will cover a brief overview of the reason for the shift from The post MACRA,MIPS and APMs- The New Era of Medicine appeared first on First Healthcare Compliance.

1st Talk Compliance
MACRA,MIPS and APMs- The New Era of Medicine

1st Talk Compliance

Play Episode Listen Later Nov 30, 2017 62:05


First Healthcare Compliance hosts Tina Colangelo, CEO of Colangelo Consulting, for an interactive discussion on “MACRA,MIPS and APMs- The New Era of Medicine”. This webinar will give attendees everything they need to know about MACRA’s Quality Payment Program all in one place! It will cover a brief overview of the reason for the shift from... The post MACRA,MIPS and APMs- The New Era of Medicine appeared first on First Healthcare Compliance.

CAPcast
Medicare’s New Quality Payment Program & the Physician Fee Schedule—What Pathologists Need to Know

CAPcast

Play Episode Listen Later Aug 25, 2017 4:42


The healthcare payment landscape is changing fast and the financial impacts for physicians could be enormous. In this CAPcast, Dr. Diana Cardona will discuss the primary issues related to Medicare’s quality program and physician fee schedule that will impact pathologists. Dr. Cardona is the Medical Director of the Surgical Pathology and Immunopathology Laboratories at Duke University Medical Center. If you are attending CAP17 in the Washington, DC, region, be sure to register for Dr. Diana Cardona’s session entitled, Medicare’s New Quality Payment Program and the Physician Fee Schedule—You Can Run But You Can’t Hide, on Monday, Oct. 9 from 2-4pm. She will be joined by other CAP advocacy leaders in teaching this course, Drs. Stephen Black-Schaffer, Patrick Godbey, and Jonathan L. Myles. Registration is now open online at thepathologistsmeeting.org.

Inside Medicare's New Payment System
Are We Prepared for MACRA and the Quality Payment Program? The Survey Says . . .

Inside Medicare's New Payment System

Play Episode Listen Later Aug 4, 2017


Host: Matt Birnholz, MD A recent survey of one thousand practicing physicians in the US, conducted by KPMG and the American Medical Association, is shedding new light on knowledge gaps in preparing for MACRA and the Quality Payment Program, and what can be done to address those gaps moving forward. Dr. Matt Birnholz speaks with Larry Kocot, Principal at KPMG and National Leader of the Center for Healthcare Regulatory Insight. Ross White, Manager for KPMG’s Center for Healthcare Regulatory Insight, and Carol Vargo, Director of Physician Practice Sustainability in the AMA Physician Satisfaction and Practice Sustainability Strategic Initiative Group about the results of this survey.

Perspectives with the AMA
Are We Prepared for MACRA and the Quality Payment Program? The Survey Says . . .

Perspectives with the AMA

Play Episode Listen Later Aug 4, 2017


Host: Matt Birnholz, MD A recent survey of one thousand practicing physicians in the US, conducted by KPMG and the American Medical Association, is shedding new light on knowledge gaps in preparing for MACRA and the Quality Payment Program, and what can be done to address those gaps moving forward. Dr. Matt Birnholz speaks with Larry Kocot, Principal at KPMG and National Leader of the Center for Healthcare Regulatory Insight. Ross White, Manager for KPMG's Center for Healthcare Regulatory Insight, and Carol Vargo, Director of Physician Practice Sustainability in the AMA Physician Satisfaction and Practice Sustainability Strategic Initiative Group about the results of this survey.

Inside Medicare's New Payment System
Are We Prepared for MACRA and the Quality Payment Program? The Survey Says . . .

Inside Medicare's New Payment System

Play Episode Listen Later Aug 3, 2017


Host: Matt Birnholz, MD A recent survey of one thousand practicing physicians in the US, conducted by KPMG and the American Medical Association, is shedding new light on knowledge gaps in preparing for MACRA and the Quality Payment Program, and what can be done to address those gaps moving forward. Dr. Matt Birnholz speaks with Larry Kocot, Principal at KPMG and National Leader of the Center for Healthcare Regulatory Insight. Ross White, Manager for KPMG’s Center for Healthcare Regulatory Insight, and Carol Vargo, Director of Physician Practice Sustainability in the AMA Physician Satisfaction and Practice Sustainability Strategic Initiative Group about the results of this survey.

Inside Medicare's New Payment System
Are We Prepared for MACRA and the Quality Payment Program? The Survey Says . . .

Inside Medicare's New Payment System

Play Episode Listen Later Aug 3, 2017


Host: Matt Birnholz, MD A recent survey of one thousand practicing physicians in the US, conducted by KPMG and the American Medical Association, is shedding new light on knowledge gaps in preparing for MACRA and the Quality Payment Program, and what can be done to address those gaps moving forward. Dr. Matt Birnholz speaks with Larry Kocot, Principal at KPMG and National Leader of the Center for Healthcare Regulatory Insight. Ross White, Manager for KPMG’s Center for Healthcare Regulatory Insight, and Carol Vargo, Director of Physician Practice Sustainability in the AMA Physician Satisfaction and Practice Sustainability Strategic Initiative Group about the results of this survey.

Inside Medicare's New Payment System
“Pick Your Pace” Options Under the CMS Quality Payment Program

Inside Medicare's New Payment System

Play Episode Listen Later Jun 23, 2017


Host: Matt Birnholz, MD This discussion is dedicated to helping clinicians understand the “Pick Your Pace” option for Merit-Based Incentive Payment System (MIPS) participation.How should physicians navigate these new reporting options to avoid any payment penalties, and what are the most effective first steps? Host Dr. Matt Birnholz welcomes Dr. Kate Goodrich, Director of the Center for Clinical Standards and Quality under the Centers for Medicare and Medicaid Services. Dr. Goodrich also serves as CMS's Chief Medical Officer.

Perspectives with the AMA
“Pick Your Pace” Options Under the CMS Quality Payment Program

Perspectives with the AMA

Play Episode Listen Later Jun 23, 2017


Host: Matt Birnholz, MD This discussion is dedicated to helping clinicians understand the “Pick Your Pace” option for Merit-Based Incentive Payment System (MIPS) participation.How should physicians navigate these new reporting options to avoid any payment penalties, and what are the most effective first steps? Host Dr. Matt Birnholz welcomes Dr. Kate Goodrich, Director of the Center for Clinical Standards and Quality under the Centers for Medicare and Medicaid Services. Dr. Goodrich also serves as CMS's Chief Medical Officer.

Inside Medicare's New Payment System
“Pick Your Pace” Options Under the CMS Quality Payment Program

Inside Medicare's New Payment System

Play Episode Listen Later Jun 22, 2017


Host: Matt Birnholz, MD This discussion is dedicated to helping clinicians understand the “Pick Your Pace” option for Merit-Based Incentive Payment System (MIPS) participation.How should physicians navigate these new reporting options to avoid any payment penalties, and what are the most effective first steps? Host Dr. Matt Birnholz welcomes Dr. Kate Goodrich, Director of the Center for Clinical Standards and Quality under the Centers for Medicare and Medicaid Services. Dr. Goodrich also serves as CMS's Chief Medical Officer.

Inside Medicare's New Payment System
“Pick Your Pace” Options Under the CMS Quality Payment Program

Inside Medicare's New Payment System

Play Episode Listen Later Jun 22, 2017


Host: Matt Birnholz, MD This discussion is dedicated to helping clinicians understand the “Pick Your Pace” option for Merit-Based Incentive Payment System (MIPS) participation.How should physicians navigate these new reporting options to avoid any payment penalties, and what are the most effective first steps? Host Dr. Matt Birnholz welcomes Dr. Kate Goodrich, Director of the Center for Clinical Standards and Quality under the Centers for Medicare and Medicaid Services. Dr. Goodrich also serves as CMS's Chief Medical Officer.

Inside Medicare's New Payment System
What Are Physician-Focused Payment Models?

Inside Medicare's New Payment System

Play Episode Listen Later Mar 16, 2017


Host: Matt Birnholz, MD The new Quality Payment Program, QPP, created by Medicare Access and CHIP Reauthorization Act, or MACRA, has generated questions from the physician community regarding how to participate, and what that participation will mean for benefiting practices. On this episode, we’ll investigate physician-focused alternative payment models, or APMs, and their emerging role in this new Quality Payment Program. Host Dr. Matt Birnholz welcomes Sandy Marks, Assistant Director of Federal Affairs at the American Medical Association to discuss APMs.

Perspectives with the AMA
What Are Physician-Focused Payment Models?

Perspectives with the AMA

Play Episode Listen Later Mar 16, 2017


Host: Matt Birnholz, MD The new Quality Payment Program, QPP, created by Medicare Access and CHIP Reauthorization Act, or MACRA, has generated questions from the physician community regarding how to participate, and what that participation will mean for benefiting practices. On this episode, we'll investigate physician-focused alternative payment models, or APMs, and their emerging role in this new Quality Payment Program. Host Dr. Matt Birnholz welcomes Sandy Marks, Assistant Director of Federal Affairs at the American Medical Association to discuss APMs.

Inside Medicare's New Payment System
What Are Physician-Focused Payment Models?

Inside Medicare's New Payment System

Play Episode Listen Later Mar 15, 2017


Host: Matt Birnholz, MD The new Quality Payment Program, QPP, created by Medicare Access and CHIP Reauthorization Act, or MACRA, has generated questions from the physician community regarding how to participate, and what that participation will mean for benefiting practices. On this episode, we’ll investigate physician-focused alternative payment models, or APMs, and their emerging role in this new Quality Payment Program. Host Dr. Matt Birnholz welcomes Sandy Marks, Assistant Director of Federal Affairs at the American Medical Association to discuss APMs.

Inside Medicare's New Payment System
What Are Physician-Focused Payment Models?

Inside Medicare's New Payment System

Play Episode Listen Later Mar 15, 2017


Host: Matt Birnholz, MD The new Quality Payment Program, QPP, created by Medicare Access and CHIP Reauthorization Act, or MACRA, has generated questions from the physician community regarding how to participate, and what that participation will mean for benefiting practices. On this episode, we’ll investigate physician-focused alternative payment models, or APMs, and their emerging role in this new Quality Payment Program. Host Dr. Matt Birnholz welcomes Sandy Marks, Assistant Director of Federal Affairs at the American Medical Association to discuss APMs.

Today's Wound Clinic's show
Episode 3: The Quality Payment Program Revolution

Today's Wound Clinic's show

Play Episode Listen Later Mar 9, 2017 37:10


How are the new quality payment programs impacting outpatient wound clinics? Podcast host Stephen G. Bergquist, MD, CWSP, speaks with Caroline E. Fife, MD, FAAFP, CWS, FUHM.

Today's Wound Clinic's show
Episode 3: The Quality Payment Program Revolution

Today's Wound Clinic's show

Play Episode Listen Later Mar 9, 2017 37:10


How are the new quality payment programs impacting outpatient wound clinics? Podcast host Stephen G. Bergquist, MD, CWSP, speaks with Caroline E. Fife, MD, FAAFP, CWS, FUHM.

This Week in Health Innovation
The Quality Payment Program: A CMS Overview

This Week in Health Innovation

Play Episode Listen Later Dec 21, 2016 84:00


A recent Medicare Learning Netork (MLN) call dove into CMS's Quality Payment Program unbundling it's core elements including MACRA, MIPS, and APMs. Introductory comments are provided by Acting Administrator, Andy Slavitt. The deck is here, and transcript is here.   

ASN Kidney News Podcast
How will the Quality Payment Program/MACRA Affect Me in 2017?

ASN Kidney News Podcast

Play Episode Listen Later Nov 16, 2016 13:30


David White, Policy and Communications Specialist speaks with Rachel Meyer, Director of Policy and Government Affairs about the Quality Payment Program (formerly MACRA) and how it pertains to you in 2017.

ASN NephWatch
How will the Quality Payment Program/MACRA Affect Me in 2017?

ASN NephWatch

Play Episode Listen Later Nov 16, 2016 13:30


David White, Policy and Communications Specialist speaks with Rachel Meyer, Director of Policy and Government Affairs about the Quality Payment Program (formerly MACRA) and how it pertains to you in 2017.

ASN Kidney News Podcast
How will the Quality Payment Program/MACRA Affect Me in 2017?

ASN Kidney News Podcast

Play Episode Listen Later Nov 16, 2016 13:30


David White, Policy and Communications Specialist speaks with Rachel Meyer, Director of Policy and Government Affairs about the Quality Payment Program (formerly MACRA) and how it pertains to you in 2017.

ASN NephWatch
How will the Quality Payment Program/MACRA Affect Me in 2017?

ASN NephWatch

Play Episode Listen Later Nov 16, 2016 13:30


David White, Policy and Communications Specialist speaks with Rachel Meyer, Director of Policy and Government Affairs about the Quality Payment Program (formerly MACRA) and how it pertains to you in 2017.