Roji Intel Blog

Thomas Dent, M.D. 0
0
Clinical Data RegistryMACRAMedical Decision-MakingMerit-Based Incentive Payment System (MIPS)Performance ImprovementQualified Clinical Data Registry ReportingRegistry ScienceResearch
July 19, 2016

MACRA Match-up: How EHR Source Data Will Benefit Registry Research

At the core of MACRA and MIPS requirements, Electronic Health Record (EHR) source data will soon become a key component for Registry research. Specifically, Clinical Performance Improvement Activities (CPIAs) are a required component of MIPS. Performance improvement efforts will no longer be optional. Quality data will be essential. EHRs present an excellent data resource, but the data is not flawless. Registries are well suited for validating data and assessing performance using a continuous improvement model—testing an idea by changing a practice and measuring its impact. When done on a small scale, testing performance improvement activities and the feasibility of population-based…
Read More
Theresa Hush 2
0
Alternative Payment Models (APM)MACRAMerit-Based Incentive Payment System (MIPS)Qualified Clinical Data Registry ReportingValue-Based Health Care
July 5, 2016

Succeed Under MACRA Medicare: How to Meet CPIAs for Full Credit in MIPS

Although many parts of MACRA’s MIPS continue Medicare’s existing quality programs, Clinical Performance Improvement Activities (CPIAs) forge a new direction. CPIAs are one of four MIPS components that practices must meet in order to obtain full reimbursement from Medicare. Forward planning is essential. It takes time to strategize and implement performance improvements, including partnerships and technology. To make this happen in 2017—the base year for performance measurement—providers must prepare before the MACRA rules are finalized. CPIAs are a unique sign of Medicare’s intent to hold practices accountable for improving health care outcomes. That’s a significant step in Medicare’s evolving role…
Read More
Theresa Hush 0
0
Alternative Payment Models (APM)Clinical IntegrationFuture of Health CareMACRAMerit-Based Incentive Payment System (MIPS)Performance ImprovementValue-Based Health Care
May 17, 2016

3 Ways Proposed MACRA Rules Revive Health Systems’ Clinical Integration Programs

Clinical Integration in medium to large Health Systems just received a nice push from the federal government’s Proposed Rules for MACRA. Health Systems trying to market quality-based physician and hospital networks systems— especially those with both employed and private physicians—should take note. This opportunity for Health Systems to bridge Medicare and private health plan quality is one of the best features of MACRA. Why? Look at this triple play of provisions woven through both MIPS and APMs: “Other-Payer” Advanced APMs will be allowed in the program’s third year to meet Advanced APM status by participating in both Health Plan and Medicare…
Read More
Robert McNutt, M.D. 0
0
Clinical Data RegistryRegistry ScienceResearch
April 19, 2016

Does Data Say All You Need to Improve Health Care Performance?

Can data lie? In a word, yes. The answer also depends on whom you ask. That goes for all forms of data analysis, including how we evaluate health care. This presents a tough dilemma for providers, patients and other stakeholders at a time when the industry and government are heavily invested in using data to compare provider performance, attach payment to “good” providers and penalties for the others. The fact is that the health care data “revolution” is in its infancy, and it is not so easy to identify two key facts: what causes outcomes, and what fixes them. Situations…
Read More
Thomas Dent, M.D. 0
0
Alternative Payment Models (APM)Future of Health CarePerformance ImprovementSpecialized RegistryValue-Based Health Care
April 12, 2016

Boutique Medicine’s Quality Challenge: Can Specialized Registries Aid Consumer Choice?

Many physicians—especially those in primary care—are angry about the practice of medicine. Dogged by high administrative overhead, they feel the pressure of shorter visit times to meet the practice’s income needs. In some geographic areas, PCPs are opting out of Medicare assignment in large numbers and establishing boutique medicine practices (including “concierge medicine”). Indeed, as CMS pushes providers toward risk under Alternative Payment Mechanisms (APMs) and away from the traditional fee-for-service, concierge medicine has become an attractive alternative for physicians who are fed up with the system. What does this trend mean for access and quality of care, especially when…
Read More
Dave Halpert 0
0
ACO ReportingAlternative Payment Models (APM)Clinical Data RegistryPQRS ReportingValue ModifierValue-Based Health CareValue-Based Payment Modifier
April 5, 2016

If Your Solution to PQRS Reporting Is an ACO, Think Again

Problems with PQRS reporting this year? As a Registry that works with groups ranging from Academic Medical Centers to solo practitioners, we’ve seen the whole gamut of issues. While there are no quick and easy solutions (sorry), the biggest myth we’re hearing this year is that you can solve all your PQRS problems by forming an Accountable Care Organization (ACO). It’s certainly true that if your ACO reports successfully—and most do—you are not required also to report for PQRS. But before you take the huge organizational leap to forming or joining an ACO, you’d best read the fine print. For…
Read More
Robert McNutt, M.D. 0
0
Clinical Data RegistryFuture of Health CareMedical Decision-MakingPerformance ImprovementRegistry ScienceResearchValue-Based Health Care
March 1, 2016

First, Ask Questions: How to Harness CDR Data for Better Patient Outcomes

As more and better clinical data becomes available and demand grows for better outcomes, the Clinical Data Registry is positioned to fulfill the role of data manager—a vital mechanism for improving care. The CDR is the engine driving a smoothly running system toward better outcomes. This involves much more than data collection. A high quality management function for CDR data requires making inferences from the data it collects. But drawing inferences from present data sources presents significant challenges, no matter how big the data source. As a medical journal editor, I have reviewed many papers from countries with massive data…
Read More
Dave Halpert 0
0
Performance ImprovementPQRS ReportingValue-Based Health CareValue-Based Payment Modifier
February 23, 2016

Don’t Hit the Medicare Revenue Wall: What You Must Know About 2016 PQRS-VBPM Benchmarks

What will it take for health care providers actually to focus on improving patient outcomes, while keeping costs under control? CMS has structured quality reporting under the Value-Based Payment Modifier (VBPM) to reward providers who surpass PQRS measure benchmarks, and penalize those who lag behind. But inherent in the new quality tiering is a serious dilemma: a strong incentive to game the system, rather than to improve performance in any meaningful way. Here’s why: For three-quarters of the individual measures included in these benchmarks, it is statistically impossible to surpass your peers’ performance. The only way to differentiate performance is…
Read More
Theresa Hush 0
0
Clinical Data RegistryMedical Decision-MakingPerformance ImprovementRegistry ScienceResearchValue-Based Health Care
February 9, 2016

Plenty of Data, Not Enough Answers: What We Need to Improve Health Care Performance

If you read the industry hype, you might believe that we’ve left the data wasteland for the data land of plenty. Some health care technology and analytics companies allege that, with all this enhanced data capability, you can now discover everything you need to know about your operations and patients that will lead you to higher profitability. But if that’s so, why are health care costs continuing to increase? Why are providers still not able to succeed under risk-based payment models? Why don’t we know more about what actually works to improve patient outcomes? It’s true that we have access…
Read More
Thomas Dent, M.D. 0
0
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…
Read More