Roji Intel Blog

Dave Halpert 0
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ACO ReportingAlternative Payment Models (APM)AttributionClinical Data RegistryPerformance Improvement
December 1, 2015

Don’t Let Wishful Thinking and Healthy Patients Harm Your ACO

Can healthy patients actually hinder your ACO’s ability to generate shared savings? Without a multi-layered strategy to improve continually over the course of the ACO agreement, the answer is yes. With the majority of ACOs failing to generate shared savings, a growing number of groups are beginning to realize that serving either the healthy or seriously ill end of the population health spectrum creates its own set of challenges. Compared to the Value-Based Payment Modifier program, ACOs are finding it nearly impossible to distinguish themselves through performance on quality measures. For ACOs to prove that they are more effectively coordinating…
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Theresa Hush 0
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Clinical Data RegistryFuture of Health CareMeaningful UseMedical Decision-MakingPerformance Improvement
November 24, 2015

Putting the “Meaning” in MU Public Health Reporting: 
How to Move Beyond “Check the Box”

Can Medicare influence health care delivery via the “public health” reporting requirements of the EHR Incentive Program? That question is central to the updated EHR Incentive Program (more commonly known as Meaningful Use, or “MU”). The answer boils down to a fundamental choice: whether providers view the external reporting Objective as just one more compliance effort, or an opportunity to improve. Apart from governmental reporting, Modified Stage 2 of MU requires eligible providers to submit data reporting to one of three types of “public health” registries: immunization, syndromic surveillance and Specialized Registries. This is reporting for the public good, and…
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Dave Halpert 0
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ACO ReportingAttributionClinical Data RegistryMeaningful UsePQRS ReportingQualified Clinical Data Registry ReportingValue-Based Payment Modifier
November 17, 2015

2016 Medicare Final Physician Payment Rule: What You Must Know

CMS’s push toward value-based care and performance improvement leaves no more room for doubt. In a hefty 1,358 pages, the 2016 Medicare Final Rule  expands the role of Qualified Clinical Data Registries for PQRS reporting, dovetailing with the Specialized/Clinical Data Registry component in the Meaningful Use Rules. Both methods place the focus squarely on how outcomes change over time, across all patients. Tracking outcomes and measuring improvement are no longer optional. Here’s what you need to know: QCDRs Get GPRO Submission Status As expected, the differentiation between the Final Rule and the Proposed Rule is minor; the most important change for…
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Theresa Hush 0
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ACO ReportingClinical Data RegistryFuture of Health CareMeaningful UseMerit-Based Incentive Payment System (MIPS)
November 10, 2015

Questions You Should Ask (or Should Have) About Medicare’s Alternative Payment Models

Are you prepared for your risk or reward under Medicare payment reforms? It’s hard to give up current revenues that reward volume, sooner than absolutely necessary. That’s the dilemma facing all providers who realize that Medicare is serious about moving 50 percent of its provider reimbursement to Alternative Payment Models (APMs) by the end of 2018. While some providers have rushed into the new system while Medicare still allows for failure to meet targets, others are waiting (including many higher cost academic medical centers). Here’s what to ask before plunging in—and if you’re already in, how to right the ship.…
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Thomas Dent, M.D. 0
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Clinical Data RegistryMeaningful UseMerit-Based Incentive Payment System (MIPS)
November 3, 2015

Making the Most of Meaningful Use: How the “Specialized Registry” Can Secure Your Future in MIPS

Good health care requires insight. That’s the message under Medicare’s new Medicare Meaningful Use rules for 2015 through 2017, giving providers the option to use a Specialized Registry to meet the Public Health Reporting Objective. The new rule also lays out how a Clinical Data Registry (CDR) will fit into this and other MU objectives in the future. Both the Specialized Registry and the CDR reflect a significant opportunity. Why? Because as these Registries collect, analyze and show data from providers who will need to report in order to be in compliance with Medicare, there will be a lot of…
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Robert McNutt, M.D. 0
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Future of Health CarePerformance ImprovementRegistry ScienceResearch
October 27, 2015

How to Harness Clinical Data Registry Power to Improve Outcomes

At the center of Medicare’s Value-Based Health Care, the Clinical Data Registry (CDR) is introducing new possibilities for outcomes improvement. Under this month’s final rules, Medicare expanded the role of Specialized Registry and Clinical Data Registry reporting in its future Meaningful Use program. Specifically, CMS initiated provider reporting to a “Specialized Registry” in 2015 as an option to meet Stage 2 requirements, while establishing the CDR as the future avenue for capturing outcome data over time. The question now is: How can we use a CDR to improve patient health? Some providers may “check the box” on Meaningful Use objectives…
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Dave Halpert 0
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ACO ReportingAlternative Payment Models (APM)Merit-Based Incentive Payment System (MIPS)Performance Improvement
October 20, 2015

Break the Barriers to ACO Shared Savings

The ACO performance results for 2014 are in, and they are troubling. While most ACOs were able to fulfill quality reporting requirements, only some reduced costs enough to qualify for shared savings. Many ACOs did cut costs—of the 353 ACOs, there were $411 million in total savings. But for most ACOs, it was not enough. How can ACOs break through the barrier to shared savings in the near future? Here are four lessons from analyzing the CMS data: The goal of Medicare’s performance-based reimbursement is to save money and improve outcomes, as illustrated by both the Merit-Based Incentive Payment System…
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Dave Halpert 0
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PQRS ReportingQualified Clinical Data Registry ReportingValue-Based Payment Modifier
October 13, 2015

ICLOPS Case Study: VBPM Consultation Lifts Specialty Group’s Quality Tier and Medicare Revenues

Medicare’s Value-Based Health Care programs aren’t just about penalties. You can also earn a reward. Case in point—an ICLOPS orthopedic client recently asked The Big Question: Are there really incentives to be earned through Medicare’s Value-Based Care? With the release on September 9 of the Annual Quality and Resource Use Reports (QRURs), the answer is a resounding “Yes.” At its core, the Value-Based Payment Modifier (VBPM) is a simple proposition: Those who are able to demonstrate higher quality care at a lower cost than other groups are rewarded, while those who can’t are penalized. The rewards come from the pool of…
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Dave Halpert 0
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Alternative Payment Models (APM)Future of Health CareValue-Based Payment Modifier
October 6, 2015

Be Prepared for Medicare’s Transition to Bundled Payments—or Risk Future Revenues

As specialists face increasing pressure to lower costs, particularly by Medicare, so-called Bundled Payments are becoming an increasingly significant—and preferred—method of reimbursement. Although this form of Alternative Payment Method (APM) is not yet mandatory, most industry experts believe that bundled payments will form the basis of how Medicare will pay specialty services in the future, especially regarding inpatient care. Develop your strategy now, or you risk economic fallout. From a fledgling pilot initiative, Medicare’s Bundled Payments for Care Improvement Initiative (BCPI) has grown to 2,100 provider groups with initiatives in one or more of 48 unique procedure or diagnosis “bundles.”…
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Theresa Hush 0
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Future of Health CarePerformance ImprovementQualified Clinical Data Registry Reporting
September 29, 2015

Big Data Analytics v Clinical Data Registry: Which Is Best for Performance Improvement?

A few weeks ago, Epic announced that it would create an unidentified database of patient data for customer research, with a plan that the “Cosmos Research Network” will leverage data for better decisions. There’s been a flurry of activity in recent years to create Big Data in health care. The Clinical Data Registry (CDR) is a variation of the concept, soon to be populated by data from Meaningful Use public reporting requirements. The question: Can both these data engines help performance improvement? The answer depends on a key distinction between Big Data Analytics and the CDR, with important implications for…
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