In this issue:

Implementing value-based physician compensation

A recent article from HFM Magazine profiles early adopters of value-based payment (VBP) models. The article presents key findings and recommendations from interviews the authors conducted with 20 provider organizations. One area the authors studied was motivation to change to this new payment model. Although their assumption of aligning performance incentives with external payment incentives proved correct, the authors also found the change was often rooted in a broader strategy, vision, and plan for the organization. The authors also discovered there was no consensus on what percentage of compensation should be tied to value. With the organizations they interviewed, the authors found it ranged from 8.5 percent to 60 percent. For those organizations looking to change to a VBP model, the authors suggest seven steps:

Register for our complimentary program on the governance of physician organizations

The transformation of health care toward more integrated and accountable delivery systems has brought physicians and hospitals together as collaborators in ever increasing numbers. With this shift has come a need to rethink and engage physician leaders in new roles, including governance.

 

To understand how the governance of physician-led organizations is different, and similar, to that of health care systems, the AHA’s Center for Healthcare Governance and Physician Leadership Forum, with generous support from Hospira, Inc., undertook a study to examine governance structures and functions in a diverse set of physician organizations.

 

Join your physician and hospital executive colleagues on Saturday, July 25 from 11:30 a.m. – 5:00 p.m. at the Marriott Marquis in San Francisco for this half-day complimentary program, in conjunction with the Health Forum/AHA Leadership Summit, to hear the highlights of the study, including case study presentations from three leading-edge physician organizations. Attendance is limited to ensure opportunity for dialogue.

 

To learn more or register for this complimentary program, click here.

Supreme Court rules in favor of continued subsidies

Last week the U.S. Supreme Court ruled 6-3 that subsidies can continue for the purchase of health insurance for qualified individuals in the 34 states where the federal government operates health insurance exchanges.

 

Plaintiffs in the case King v. Burwell had challenged the validity of the subsidies, arguing that only individuals in states with a state-based insurance exchange were eligible under the language in the Affordable Care Act.

 

American Hospital Association (AHA) President and CEO Rich Umbdenstock said, „[This] is a significant victory for protecting access to care for many of those who need it. America’s hospitals will continue to advocate for coverage for all, an essential part of better health and better health care for Americans.”

 

Chief Justice John Roberts wrote the court’s majority opinion, joined by Justices Anthony Kennedy, Stephen Breyer, Ruth Bader Ginsburg, Elena Kagan and Sonia Sotomayor. Justice Antonin Scalia wrote the dissent, joined by Justices Clarence Thomas and Samuel Alito.

 

For analysis on the ruling by AHA outside counsel Sean Marotta, a Hogan Lovells associate focused on appellate and Supreme Court litigation, visit the AHASTAT blog.

Study questions effectiveness of computerized clinical decision support systems

Computerized clinical decision support (CDS) systems have the potential to improve care, but implementing CDS systems in real-world settings has many challenges that must be addressed to meaningfully affect patient care, according to a study published recently in the Journal of the American Medical Association. The study used data from the Medicare Imaging Demonstration to evaluate the relationship of CDS system use with the proportion of imaging orders matched to appropriate criteria, the appropriateness of ordered images and the proportion of orders changed following feedback. „Most orders were unable to be matched by the CDS systems to appropriateness criteria,” the study notes. The Protecting Access to Medicare Act mandates use of CDS systems for the ordering of advanced diagnostic imaging in Medicare starting in 2017.

Survey looks to evaluate the effectiveness of transitional care

The American Hospital Association (AHA) and the Health Research & Educational Trust (HRET) are collaborating with the Project ACHIEVE team, which is evaluating the effectiveness of transitional care.

 

An important part of the project is surveying hospitals across the United States to catalog efforts at improving hospital discharge transitions. AHA/HRET strongly support the efforts of Project ACHIEVE and believe the findings from it have the potential to help us, patients, caregivers, and providers.

 

Below is a link to the survey, which is housed on a secure server.

https://redcap.uky.edu/redcap/surveys/?s=4JLFAATYXP.

 

The survey should take about 15 to 20 minutes to complete, and someone at your hospital in case management, quality improvement, or administration would likely be the best person to do this, with help from clinicians (i.e., nurses, pharmacists, physicians). AHA/HRET ask that you complete the survey by July 31, 2015. If you have any questions, please contact Marie Cleary-Fishman at [email protected].

CMS issues 2013 data on Medicare service use, payments for hospitals, physicians

The Centers for Medicare & Medicaid Services recently released 2013 data on average charges and payments for hospitals, physicians and other suppliers under Medicare Parts A and B. The annual update includes hospital-specific data for the 100 most common inpatient Diagnosis-Related Groups and 30 select outpatient Ambulatory Payment Classifications, and physician/supplier-specific data for services and products using the Healthcare Common Procedure Coding System.

AHRQ regional cooperatives to promote heart healthy primary care

The Agency for Healthcare Research and Quality recently awarded $112 million to create seven regional cooperatives to help up to 300 small primary care practices improve heart health for patients. The EvidenceNOW initiative will help the practices incorporate key evidence-based interventions to reduce cardiovascular risks: aspirin use by high-risk individuals, blood pressure control, cholesterol management and smoking cessation. Services will include onsite coaching, consultation from experts, sharing best practices and electronic health record support. An eighth awardee will evaluate the impact of the interventions on practice improvement and the delivery of cardiovascular care. The initiative is supported by the Patient-Centered Outcomes Research Trust Fund.

ABMS/AAMC call for MOC activities

The American Board of Medical Specialties (ABMS) in partnership with the Association of American Medical Colleges (AAMC) is developing the ABMS Maintenance of Certification (MOC) Directory powered by MedEdPORTAL (ABMS MOC Directory), an online repository of competency-based MOC activities.

 

Phase One of this partnership is the ABMS/AAMC Call for MOC Activities. All members of the continuing professional development and continuing medical education communities are invited to submit relevant educational activities for review and inclusion in the ABMS MOC Directory by July 31, 2015. This is an opportunity for all stakeholders to engage in the development of Lifelong Learning and Self–Assessment (Part II) and Improvement in Medical Practice (Part IV) activities designed to improve the quality of patient care.

 

To submit an activity for review and inclusion in the ABMS MOC Directory, fill out the Common MOC Activity Submission Form at www.mededportal.org/abms.

Improving a physician’s communication skills

A recent article from H&HN Daily discusses how physicians can improve their communication skills. According to the article, doctor’s communication skills are now being rated on the Center for Medicare & Medicaid Services’ HCAHPS Survey, and how they perform will be linked to reimbursement. The article lists three ways hospitals can help physicians improve their communication skills:

The article goes on to discuss ways to engage physicians to improve HCAHPS scores such as removing barriers to efficient practice, improving trust, and providing communication training.

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