Bundled payments, a health care payment innovation that has been widely praised for controlling costs, recently got a bad rap. Secretary of Health and Human Services Tom Price has delayed implementation of the final Medicare rule for several bundled payment programs that were set to start this year. He has criticized the bundled payments initiative […]
Turning Patients into Health Care Consumers—For Economic Survival
If we want to help people take better charge of their health—both physically and financially—we should start by treating them as real consumers, instead of patients. While that may seem like a simple change in terminology, it is anything but. A Patient Is a Recipient of Services, Not the Actor Health care organizations often work […]
The Dirty Little Secret About Performance Measurement Data
“The data just hooks up.” That was an opening remark from a competitor applauding his company’s scoring system for physician quality. He went on to explain how this data produced reliable scores on quality. The idea that data hooks up and produces a true scoring system for quality is a fantasy. Not only is data […]
Real Patient Empowerment Depends on Real Performance Measurement
“Patient empowerment” is a new term to watch. It’s a banner for some health care reform initiatives being proposed in lieu of the Affordable Care Act (ACA). In fact, “Empowering Patients First” is the title of legislation introduced by Congressman Tom Price (nominee for Secretary of the Department of Health & Human Services, which oversees Medicare […]
Can Health Care Stay the Course of Reform Amidst Uncertainty?
With the new year finally here, health care organizations need to know: How should you proceed amidst uncertainty about Medicare policy, including Value-Based and Risk programs initiated by the Obama administration? In the crosshairs are the new, complex Quality Payment Programs under MACRA, including both MIPS and Alternative Payment Models (APMs) such as ACOs. Although […]
Your Wish List for MACRA Performance Improvement Technology
Even as CMS has eased the transition to MACRA with the Final Rule published on October 14, managing under Risk remains a core goal. The best way to prepare your organization? Develop MACRA Improvement Activities (formerly CPIAs), the training ground for managing under Risk. The MACRA Improvement Activities cover all of the processes and root causes […]
Physician Culture Must Transition from Defensiveness to Performance Improvement
Physicians undergo long and arduous training, with good reason. Lives are at stake. Learning to make the correct diagnosis, to expertly perform the appropriate procedure and to properly treat conditions is essential. Mistakes or flaws are scrutinized and not tolerated. Being wrong may cause greater harm to the patient—and lead to malpractice litigation. In short, […]
Improve Your Risk Readiness With Physician-Driven MACRA CPIA Innovation
CMS is pushing providers to accept Risk under Alternative Payment Models (APMs), and they’re sweetening the pot with incentives. But for the vast number of providers who will participate in MIPS because they don’t participate in risk-based APMs, the path to reward is murky. That’s because many Health Systems have a hard time visualizing how […]
Boost Your MIPS Score with Care Coordination CPIAs—Your Patients Will Thank You
The reaction to MACRA Pick Your Pace speaks volumes about the state of preparedness for the upcoming Quality Payment Program (QPP). Some see Pick Your Pace as a reprieve, others see it as a parachute, and a select few see it as a way to get a head start on their peers. There’s a danger […]
MACRA APM Risk: 5 Keys for Redefining Performance Improvement
Whatever relief providers felt after the recent CMS MACRA Pick Your Pace announcement, don’t be fooled. CMS has not, it seems, backed off its goals of pushing providers toward Risk, nor the interim and final quotas for participation. To the contrary—the announcement pointedly suggested that providers consider joining a risk-based Alternative Payment Model (APM) in […]