Thursday, March 31, 2016
Wednesday, March 30, 2016
Tuesday, March 29, 2016
Study: Primary Care Doctors Often Don’t Help Patients Manage Depression | Kaiser Health News
Study: Primary Care Doctors Often Don’t Help Patients Manage Depression | Kaiser Health News
This study focused on adult patients and no specific pediatric data, e.g. for adolescents, is noted.
This study focused on adult patients and no specific pediatric data, e.g. for adolescents, is noted.
Monday, March 28, 2016
Friday, March 25, 2016
Thursday, March 24, 2016
Wednesday, March 23, 2016
Tuesday, March 22, 2016
Monday, March 21, 2016
Medicare to Unveil Overhauled Requirements for Doctor Pay Soon
Medicare to Unveil Overhauled Requirements for Doctor Pay Soon
By Kerry Young, CQ Roll Call, March 17, 2016
Medicare within months will unveil its draft proposal for carrying out a major overhaul of its payments for physicians, with agency officials on the hook to make myriad decisions about judging the quality of service provided to the nation’s elderly and disabled.
Patrick Conway, the chief medical officer for the Centers for Medicare and Medicaid Services, on Thursday told a House Energy and Commerce panel that the draft will be released this spring. Doctors and others with an interest in Medicare policy will then have 60 days to comment on the rule. Medicare spent $69.2 billion in 2014 for the services of about 576,000 physicians and 315,000 nurse practitioners, physician assistants, therapists, chiropractors, and other professionals, according to a recent report from the Medicare Payment Advisory Commission.
The CMS rule will be a key tool for carrying out the payment changes mandated by last year’s overhaul (PL 114-10) of physician reimbursements, considered one of the most significant recent federal health laws. The measure stopped what had been a near Sisyphean task for Congress every year of overriding a previous budget law’s mandate for cuts in physician pay through a series of often hastily passed “doc fix” bills that held at bay payment reductions.
“It is a little bit surreal to be here discussing the implementation of this Medicare provider payment reform,” Rep. Michael C. Burgess, R-Texas, a doctor, said at the hearing. “So many times we were here worried about how we were going to keep the dire wolf away from the door for yet one more time, to stop a substantial double-digit cut."
Burgess and other lawmakers on the Energy and Commerce Health Subcommittee told Conway that they will watch closely as his agency brings forward the new payment system. Because the draft is not yet public, there was little cause for argument between the lawmakers and Conway at the hearing.
Medicare in recent years already had begun to tie some quality measure to payments for doctors in its traditional fee-for-service system. The stakes tied to judgments made via quality measures rise under the new payment framework created by Congress.
The new framework, known as a merit-based incentive payment system, takes effect in 2019. Physicians will see their Medicare reimbursement rise or fall based on how well they score in the new system. Cuts are generally limited to 4 percent in 2019, rising to 5 percent in 2020, 7 percent in 2021, and 9 percent in 2022. Doctors also have the option of working with Medicare outside of the MIPS program by participating in alternative payment models such as accountable care organizations. These programs already seek to tie reimbursement to judgments about quality.
At the hearing, Conway reminded lawmakers the agency already has met a goal of tying 30 percent of traditional, or fee-for-service, Medicare payments to alternative payment models, a level that it earlier expected to reach later in the year.
Not all doctors are enthusiastic converts to alternative payment systems. The overhaul of Medicare payments will be highly disruptive, Burgess said. Many physicians would prefer having fewer demands attached to their Medicare reimbursement. Burgess said many of his fellow doctors are nervous about how the changes will affect them, and prefer they not take place. Still, he conceded a broad shift in attitude about what Medicare can demand in return for its payments.
“If I had been able to do this the way I would have wanted, I would have simply directed CMS to pay whatever bills come in over the transom and stop bothering everybody,” Burgess said of the reimbursement overhaul at the hearing. “We all know that wasn’t a realistic approach.”
Sunday, March 20, 2016
Thursday, March 17, 2016
Wednesday, March 16, 2016
Tuesday, March 15, 2016
Quality reporting’s toll on physician practices costs time and money
Quality reporting’s toll on physician practices costs time and money
- Modern Healthcare
- 14 Mar 2016
- By Sabriya Rice
Indiana University Health is in the midst of a multiyear effort to streamline the quality measures that front-line providers are expected to track. The information is intended to help monitor and improve the quality of healthcare, but collecting it also saps resources.
“It’s a lot of time and effort spent at the computer documenting things that don’t impact patient care,” said Dr. Jonathan Gottlieb, the Indianapolisbased system’s chief medical executive.
Researchers at Weill Cornell Medical College in New York City teamed up with the Medical Group Management Association to put a price on the time providers spend to enter the quality data into the electronic health record, keep track of newly introduced measures and create protocols to track and report them. The answer is about $15.4 billion a year, according to their study published March 7 in Health Affairs.
That’s “a large amount of money being wasted on checking this box and that box,” said lead study author Dr. Lawrence Casalino, chief of the division of health policy and economics at Weill Cornell. “It’s time physicians could spend on not rushing a patient, or thinking about a diagnosis more carefully.”
In the study, researchers surveyed 394 leaders from cardiology, orthopedics, primary care and internal medicine practices. They asked how much time specialty clinicians spend on tasks associated with collecting the data and then converted those hours into costs based on how much the clinicians are paid.
Across all specialties, licensed practical nurses and medical assistants spent the most time. For example, between 2014 and 2015, LPNs and medical assistants in primary-care settings spent an average of 7.8 hours a week on quality reporting tasks. That’s about $9,119 a year for each clinician. The authors noted several limitations of the study. Practices with stronger negative feelings about quality measures may have been more likely to respond, which could have distorted the estimates.
IU Health set up a clinical economics committee to keep track of what measures must be reported for each department or specialty, as well as the rewards and penalties on the line. For clinicians, however, the team is striving to boil down all of the measures to the basics. By the beginning of 2017, IU Health plans to cut the number of measures specialty doctors must track to about 10 or fewer. The system did the same last year for its hospital measures, cutting the number of inpatient metrics clinicians must input from 199 to 10.
“Someone needs to pay attention,” Gottlieb said. “But we want our doctors and nurses to focus on measures that contribute directly to the welfare of the patient.”
Monday, March 14, 2016
Friday, March 11, 2016
Thursday, March 10, 2016
Wednesday, March 9, 2016
Tuesday, March 8, 2016
Monday, March 7, 2016
Thursday, March 3, 2016
Wednesday, March 2, 2016
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