Roji Intel Blog

Thomas Dent, M.D. 0
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ACO ReportingAlternative Payment Models (APM)Clinical Data RegistryFuture of Health CareMeaningful UseMerit-Based Incentive Payment System (MIPS)Performance ImprovementRegistry ScienceResearchValue-Based Health Care
February 2, 2016

All Together, Now: Why Specialists Need the CDR Edge for Bundled Payments

With the advent of Bundled Payments for selected procedures and conditions, providers and institutions must collaborate to meet both cost and quality targets. No longer will each provider bill and receive payment separately for services when these bundles become mandatory—as most experts believe will happen. All providers participating in a set “bundled” price must focus on coordinated performance improvement or face penalties. Key to that effort: a Clinical Data Registry (CDR) that tracks patient outcome data over time and pinpoints success or failure of interventions. CDR Performance Improvement Tools Are Essential for Bundled Payments Success The CDR fulfills two fundamental…
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Theresa Hush 0
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ACO ReportingClinical Data RegistryFuture of Health CarePerformance ImprovementRegistry ScienceResearchValue-Based Health Care
January 26, 2016

Why Traditional VBHC Trouble Shooting Will Get You in Trouble with Performance Improvement

You’ve heard the phrase. You know it’s a key goal in Value-Based Health Care. But many providers don’t understand the full meaning of performance improvement. All too often, health care systems rely on piecemeal, troubleshooting approaches that emphasize short-term gains over meaningful, improved outcomes. Here’s a common example: Almost every hospital has adjusted its discharge process to avoid readmissions. But unless they can explain why patients were readmitted—few actually can—gains will diminish. New patients presenting with the same high-risk conditions will challenge reduction of readmissions because efforts addressed the symptom but not the root cause. Improving performance means more than…
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Robert McNutt, M.D. 0
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Clinical Data RegistryFuture of Health CarePerformance ImprovementRegistry ScienceResearch
January 19, 2016

The CDR Advantage: Why Registry Research Minimizes Study Bias for Performance Improvement

The Clinical Data Registry is a powerful research tool for improving patient health. But what makes Registry-based study design better than pre-post study design? The answer has far-reaching implications for how we will use data to determine treatment effectiveness in the future, as well as how we will meet the challenge of improving health outcomes. Research can be built on the case-control study, observational study designs, N-of-1 study designs, randomized trials or the N-of-1 population study. Most of these approaches—except those facilitated by a Registry—will be limited by small patient samples due to the patient selection process. But that’s a…
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Thomas Dent, M.D. 0
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AttributionClinical Data RegistryFuture of Health CareMeaningful UsePerformance ImprovementValue-Based Health Care
January 12, 2016

Public Health Reporting for Specialists: Avoiding Penalties Isn’t the Only Reason to Comply

At the heart of CMS’s Public Health Reporting Requirements for Meaningful Use is a basic premise: EMR technology must facilitate tracking of public health trends and long-term outcomes improvement. That is why all providers in the Meaningful Use program, regardless of specialty, are now being required to engage in public health reporting to avoid a penalty. Many specialists don’t see the point of reporting for public health reasons or find it too difficult. While it’s true that specialists face some specific challenges that require dedicated reporting to fit their clinical operations and to avoid professional and financial risks, there are…
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Dave Halpert 0
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ACO ReportingAlternative Payment Models (APM)AttributionClinical Data RegistryFuture of Health CarePerformance ImprovementValue-Based Health Care
January 5, 2016

Bundled Payments Aren’t Mandatory for Everyone (Yet): Is Your Group Ready?

It’s taken more than a half-century, but the Medicare Final Rule on Comprehensive Care for Joint Replacement (CCJR) has set in motion utilization reporting that will shift the focus from static data about diagnoses, services and days in hospital to meaningful information about care transitions and outcomes. It’s taken a long time. But now that we’re here, the train is leaving the station. The big question facing providers: with Medicare’s push to ensure that compensation from Alternative Payment Models (APMs) accounts for half of reimbursements by 2018, is a Bundled Payment the best APM for you and your group? A…
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Theresa Hush 0
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Clinical Data RegistryFuture of Health CarePerformance ImprovementValue-Based Health Care
December 22, 2015

Happy New Year: Higher Patient Financial Responsibility Risks More Provider Debt

A few weeks ago, we learned that the rate of health care spending has escalated, with a 5.3 percent gain in 2014—accounting for 17.5 per cent of the U.S. Gross Domestic Product. And, according to the Kaiser Foundation, this predicted upward trend shows no signs of abating anytime soon. At some point, this cost burden on the economy is unsustainable. So where is the outcry? The relative silence around the trend, compared with prior decades, reveals a shift in financial responsibility from employers to individuals, which just might crack the foundations of the health care system. Consumers are Paying More…
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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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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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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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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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