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CMS releases MACRA rule proposal: Will HHS force physicians to drop fee for service for fee for outcome?

Streamlined implementation aims to increase flexibility, decrease reporting burden for physicians

The U.S. Department of Health and Human Services unveiled a proposed ruletackling the initial implementation of the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA).

According to an HHS announcement accompanying the rule, the primary aim is to simplify and streamline the existing patchwork of value-based payment models that have increasingly replaced the traditional fee-for-service system via a new framework dubbed the Quality Payment Program. This structure provides doctors with two paths for compliance:

The Centers for Medicare & Medicaid Services expects most providers to opt for the MIPS track initially, according to CMS Acting Principal Deputy Administrator and Chief Medical Officer Patrick Conway, M.D., who spoke on a conference call announcing the rule.

Participation in Advanced Alternative Payment models would exempt doctors from MIPS reporting requirements while also qualifying them for financial bonuses in exchange for taking on the risks related with providing “coordinated, high-quality care,” according to CMS. The agency expects both the number of physicians participating in this track and the number of payment models available to grow over time.

CMS also reports that doctors will have the flexibility to switch among various components of the Quality Payment Program as dictated by the needs of their patients or their practices.

Opinions from around the web

In this video, Gilberg, senior vice president for the Medical Group Management Association’s Government Affairs Office, discusses CMS’ Physician Value-based Payment Modifier. In 2015, Medicare will begin applying the modifier under the physician fee schedule to various providers to show value of care.

“Cost and quality … make up the value equation, in the mind of the payer, in terms of Medicare,” said Gilberg.

In addition to explaining how the modifier works, Gilberg also highlights other quality measures facing providers under the Physician Quality Reporting System and via the EHR Incentive Programs, better known as meaningful use.

View Video at

http://www.physicianspractice.com/mgma14/understanding-medicare-value-based-payment-models

When the Medicare Access and CHIP Reauthorization Act (MACRA) legislation passed in April 2015, everyone cheered the repeal of the Sustainable Growth Rate (SGR) formula for Medicare physician payment. Now, even before the MACRA regulations are even promulgated, it’s time to pay attention because Medicare physician payments in 2019 will be impacted by their performance in 2017, just a year from now.

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Patients First

Larry H. Bernstein, MD, FCAP, Curator

LPBI

 

Office of Patient Experience

http://my.clevelandclinic.org/patients-visitors/patient-experience

 

Cleveland Clinic defines our patient experience as putting “Patients First”.

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Putting patients first requires more than world-class clinical care – it requires care that addresses every aspect of a patient’s encounter with Cleveland Clinic, including the patient’s physical comfort, as well as their educational, emotional, and spiritual needs. Our team of professionals serves as an advisory resource for critical initiatives across the Cleveland Clinic health system. In addition, we provide resources and data analytics; identify, support, and publish sustainable best practices; and collaborate with a variety of departments to ensure the consistent delivery of patient-centered care.

Cleveland Clinic was the first major academic medical center to make patient experience a strategic goal, appoint a Chief Experience Officer, and one of the first to establish an Office of Patient Experience.

 

Patient Experience Measurement

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How We Measure Patient Experience

All acute care hospitals throughout the United States participate in a patient survey process designed and regulated by the Centers for Medicare and Medicaid Services (CMS). This HCAHPS survey (Hospital Consumer Assessment of Healthcare Providers and Systems) measures patients’ perspectives of their hospital care.

Public results are available at hospitalcompare.hhs.gov. Eligible adult patients are surveyed after hospital discharge and results displayed represent four consecutive calendar quarters.

Due to a time lag of the published HCAHPS survey results, we believe it is important for you to see our most recent feedback. View our HCAHPS scores from the last public reported period as well as our recent performance.

HCAHPS Education and Data Coordination

The Intelligence Team in the Office of Patient Experience plays a vital role in coordinating survey data transmission between the survey vendor and the Cleveland Clinic system. Real-time survey results, complete with benchmark comparisons and performance indicators, are maintained on an internal web-based dashboard program available to all staff in leadership and management roles. The team also provides survey education, particularly for the CMS-required inpatient HCAHPS survey process, and works together with leadership to uncover feedback trends and help prioritize experience improvement efforts.

 

Patient Experience: Empathy & Innovation Summit

Patient Experience: A Key Differentiator

Patient experience has emerged as a dynamic issue for healthcare executives, physicians, nursing executives and industry leaders. No provider can afford to offer anything less than the best clinical, physical and emotional experience to patients and families. As patients become savvier, they judge healthcare providers not only on clinical outcomes, but also on their ability to be compassionate and deliver excellent, patient-centered care.

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