Roji News Roundup: Fall 2019 Edition

In a range of recent industry publications, Roji Health Intelligence CEO Terry Hush shares her insights on the latest moves by CMS and health care trends:

Are Value-Based Models Helping or Hindering Care Delivery for Primary Care Providers
AJMC Managed Markets Network, October 10, 2019

This article by Jaime Rosenberg summarizes Terry’s presentation at the National Managed Care Physicians 2019 Fall Managed Care Forum in Las Vegas. Value-based models continue to enter the health care system, affecting a variety of fields, including primary care. And while success stories have been shared by payers and CMS touts these models as a way to “save” primary care, Terry explains why revising payment models without changes by practice won’t be enough.

How primary care physicians can navigate business intelligence challenges under risk models
HFM, September 5, 2019

Terry explains how primary care physicians have been enlisted in the Value-Based Health Care effort, with revenues linked to meeting targeted cost measures to entice practice participation. But many of these physicians lack the business intelligence capabilities needed to be successful under these models.

As MIPS, practice hassles get harder, pay-for-performance gets more attractive
Decision Health/Part B News, September 5, 2019

Terry is among the experts quoted in this article by Roy Edroso that examines how MIPS requirements and fee-for-service may be driving some providers out of business or into new payments systems preferred by CMS.

Nine Reasons Health Execs Are Excited for the Future
Managed Healthcare Executive, August 26, 2019

One of nine health care execs quoted in this roundup by Tracey Walker, Terry highlights the trend toward consumer empowerment in managing their medical decisions and costs as a game changer in health care cost control.

5 Actions ACOS Should Take Now: Takeaways from Proposed CMS
ACO Newstand Weekly, August 15, 2019

Terry explains why ACOs should take a holistic approach to reading CMS’s proposed revisions to the PFS and QPP, as well as the proposed Outpatient Prospective Payment System (OPPS) rule.

Three key quotes on bundled payments in ASCs
Becker’s ASC Review, July 11, 2019

Terry is one of three experts quoted on this top-of-mind issue for many ASC leaders.

Founded as ICLOPS in 2002, Roji Health Intelligence guides health care systems, providers and patients on the path to better health through Solutions that help providers improve their value and succeed in Risk. Roji Health Intelligence is a CMS Qualified Clinical Data Registry.

Image: Robert Bye