Roji Intel Blog

Robert McNutt, M.D. 0
0
Population HealthRegistry ScienceResearch
February 24, 2015

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 to chart a specific, systematic course. Talking without specificity about “population health” can lead to thinking as murky as my claim to cure breast cancer. Population health is sometimes defined so broadly that it becomes meaningless.  Unfortunately, population health has also become synonymous, for some people, with…
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Theresa Hush 0
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Population HealthPQRS ReportingQualified Clinical Data Registry ReportingValue-Based Payment Modifier
February 10, 2015

Navigating the ACO Labyrinth to Success: How to Find Your Way to Quality and Shared Savings

Last year, less than one quarter of Medicare MSSP ACOs achieved success in generating shared savings. Not a good report card, given that Accountable Care Organizations form for the explicit purpose of delivering high quality, coordinated care, with shared savings as in incentive to avoid duplication of services. But ACOs are complex endeavors, both administratively and clinically. Better coordination of patient care does not guarantee success. Your efforts must be complemented by a solid understanding of Medicare’s basic rules for quality reporting and methods of attributing patients to the ACO, so that you can keep your patients within the network.…
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Thomas Dent, M.D. 0
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Future of Health CarePopulation HealthPQRS ReportingValue-Based Payment Modifier
January 27, 2015

How Medicare is Moving from PQRS Basics into Value-Based Care: Improving Outcomes with Plan of Care

For a number of PQRS measures, Medicare requires that the provider document a Follow-up Plan or Plan of Care to demonstrate that appropriate interventions have been made to reduce risk. This has caused confusion and consternation among some of our clients who may not have clearly documented the follow-up plan or may disagree with Medicare on the plan’s criteria. Nonetheless, documentation of risk-reduction interventions is in keeping with CMS plans to transition all reimbursement into Value-Based Care, so it’s essential to understand how to manage this process. In fact, just this past Monday, January 26, Health and Human Services Secretary…
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Dave Halpert 0
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Population HealthPQRS ReportingQualified Clinical Data Registry ReportingRegistry ScienceValue-Based Payment Modifier
January 20, 2015

Avoid PQRS and VBPM Penalties and Achieve Long Term Revenues: How to Choose the Right QCDR

Can you optimize your Value-Based Payment Modifier (VBPM) quality and cost profile to demonstrate better outcomes than others and avoid both PQRS and VBPM penalties at the same time? Yes: Use a Qualified Clinical Data Registry (QCDR) to do both. In 2014, the initial year of QCDR reporting, providers had the opportunity to report non-PQRS measures, but still get credit for participating in PQRS. This year, Medicare has provided additional freedom by giving QCDRs the chance to report 30 non-PQRS measures for PQRS, up from last year’s 20. Providers are required to report an additional outcome measure this year (two,…
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Robert McNutt, M.D. 0
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Medical Decision-MakingPopulation HealthQualified Clinical Data Registry ReportingRegistry ScienceResearch
January 13, 2015

Are “Flat-Line” Outcomes the Kiss of Death? How to Use a Registry for Outcomes Improvement Research

Despite a huge investment in health care, we have yet to demonstrate real progress in improving outcomes. A major study of patient outcomes last year revealed disappointing “flat-line” results for patient-centered medical home services, which means no difference in outcomes over time, regardless of significant expenditures. And that’s just the beginning.  Assessments of cancer outcomes, preventive screenings and chronic disease indicators show similar, disappointing results. It’s hard to accept that we have failed to improve mortality or morbidity in a way that can be attributed to medical management and treatment, rather than to lifestyle and nutrition. In most cases, however, that’s where…
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Thomas Dent, M.D. 0
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Population HealthPQRS Reporting
December 9, 2014

How to Energize Your Providers to Measure and Improve Outcomes

It’s no wonder that so many physicians feel threatened by the mention of outcomes measurement. All too often, outcomes are used as a club to punish providers who seem to weaken overall group performance. Or outcomes are packaged and applied in a way that doesn’t provide actionable information—which can seem like a waste of everyone’s time and resources. To engage your providers—and get the real benefit from this form of health care data analysis—try to link your efforts to measure and improve outcomes with an iterative process of inquiry into best practices. Why Outcomes Measurement Can Seem Misleading Measuring patient…
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Thomas Dent, M.D. 0
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Population HealthPQRS Reporting
December 2, 2014

No More Blame Game: How to Use Patient Outcomes Measurement to Boost Quality and Provider Performance

Fair or not, if your patients don’t do well, your physicians can be tagged as poorly performing providers. But there are ways to change the dynamic for your organization by effectively using patient outcomes measurement to structure and drive a quality program that benefits both patients and providers. Tracking the health and status of patients—“how patients do”—is the Holy Grail of quality measurement. Despite the fact that it is very difficult to identify a direct cause and effect between provider action and patient outcomes, quality programs are shifting the emphasis to patient outcomes and attributing performance to physicians. This is…
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Theresa Hush 0
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Population HealthPQRS ReportingValue-Based Payment Modifier
November 18, 2014

PQRS 2015: How Your Practice and Patients Can Benefit from New Population Health Measures

Good news for providers who have criticized PQRS as mundane and want to improve assessment of patient outcomes and reduce gaps in care: Medicare’s PQRS 2015 Rule is shifting away from rewarding fragmented quality services and toward population health. With the expansion of the related Value-Based Payment Modifier (VBPM), every group can turn population health into higher Medicare revenues, so long as you have strong, patient-centric processes—and data capture. If you don’t, you may suffer penalties. What’s a Cross-Cutting Measure and How Does It Work? CMS has established a set of Cross-Cutting Measures to provide a broader evaluation of care…
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Thomas Dent, M.D. 0
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Medical EducationPopulation HealthResearch
October 28, 2014

The Missing Dimension of Residencies That Will Affect Your Program’s Future

Residency programs need to change. I write this as a former family medicine residency program director who spent much of my professional life teaching residents and medical students. Specifically, residency programs need to get on track in the value-based health care world. To fail to do so is to become obsolete. Here‘s the problem: Like most residency programs, our teaching focused on individual patients, in both the office or in the hospital. While we treated specific conditions and used protocols, however, we never evaluated performance of a patient population, particularly over an extended time frame. Quality Measurement is Now Central…
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Robert McNutt, M.D. 0
0
Population HealthResearch
October 22, 2014

Research Revolution: Why Everyday Medical Decisions Need More Science

How can a physician know when a treatment actually works? Let’s examine the case of outcomes for patients with asymptomatic bacteriuria. In a recent study, patients with the diagnosis were randomized to receive either an antibiotic or a placebo; the outcome measure was the proportion who developed symptomatic bacteriuria. The findings? Both groups had nearly the same proportion of symptomatic bacteriuria at the end of the study. Clearly, the antibiotic made no difference in outcomes. But this can be a hard sell, not only for patients who expect their physicians to “do something,” but also for physicians, who believe that…
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