For the past couple of years, “population health” has become a popular catchphrase. Everyone is talking about it, adopting it or selling it. But if you ask anyone what it means, you’ll get very different answers. That’s because there seems to be only one point of consensus—we need to focus health care efforts on specific […]
Prove You’re a Top Tier Health Care Provider: Six Essentials for Your Value-Based Purchasing Game Plan
You know you need to shift your organization toward Value-Based Health Care. It’s a trend that’s here to stay, and you’re deep into planning your strategy. Question is, what’s the right game plan that will enable you to reap financial benefits by proving you’re a top-tier provider that offers quality, cost-effective health care? All too […]
Better Hypertension and Diabetes Outcomes: From Basic Measurement to a Plan for Improvement
Are you caught in a squeeze between avoiding penalties in both PQRS and the Value-Based Payment Modifier (VBPM)? Medicare’s move to Pay for Performance has created a Catch-22 for many groups: you may have enough data to report enough PQRS measures, but if you choose to report measures where your performance is below the CMS […]
Your VBPM Incentive Payment Could Be Higher Than You Expect—If You Act Now
Here’s a lesson in budget neutrality, Medicare style: If you are penalized under PQRS for non-reporting or under the Value-Based Payment Modifier (VBPM) for poor performance, your money will be paid out to providers earning a VBPM incentive. That’s right—to your competition. If you’re on the losing end of this equation, you could lose up […]
How to Organize Your Academic Medical Center for PQRS 2015 Success
Take a deep breath. The last-minute flurry of adjustments and updates to last year’s PQRS reporting is over. And—brace yourselves. It’s time to dig into PQRS 2015, which, if you’ve been following our posts, requires a whole new level of rigor to avoid penalties under Pay for Performance. (Download our free eBook, Insider’s Guide to […]
Academic Medical Centers at Risk: How to Survive Medicare and Medicaid Value-Based Health Care
Academic Medical Centers (AMCs) provide care to the most complicated patients and have surmounted some of the worst clinical challenges of all time. Yet the biggest issue to threaten survival of AMCs might well be Medicare and Medicaid Value-Based Purchasing. While AMCs incorporate the training of new physicians in both community and highly specialized care, […]
ACO v Group Practice P4P: How Medicare Costs and Quality Calculations Affect Your Bottom Line
Now that Value-Based Health Care defines the landscape, reporting for revenue is on its way out. Value-based quality is in. Medicare’s transition to Pay for Performance gives providers just three options—and no out—for participating in reimbursement models that reward for higher quality and lower cost: Build or participate in an Accountable Care Organization; Report PQRS […]
PQRS 2014 Last Minute Checklist: What You Can and Can’t Do Now
With just a few days to go before the final reporting deadline, it’s time to cross the t’s and dot the i’s on PQRS 2014. There may be a few practices still trying to put together a reporting program, but almost everyone using a Registry and who has done the work is ready to […]
Placebo v Nocebo: How to Test Methods of Physician Engagement in Population Health
The Holy Grail for value-based health care is to improve patient quality and cost outcomes, while stabilizing or reducing annual aggregate payouts for insurance and government benefits. By holding physicians and health systems accountable, the theory goes, providers will engage with patients in a process leading to better status and lower costs. The key word […]
Population Health: What Should It Really Mean?
A long time ago, on my first day of an Oncology fellowship, my soon-to-be-mentors asked me if I had a research interest. “Yes,” I said, “I want to cure breast cancer.” Their kind smiles belied their recognition of my naïveté. In retrospect, thinking too broadly leaves one adrift. To navigate to your goal, you need […]