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MACRA News: AHA calls for additional flexibility in physician quality payment program
The American Hospital Association (AHA) has urged the Centers for Medicare & Medicaid Services (CMS) to expand its proposed definition of advanced alternative payment models for the physician quality payment program. „We urge CMS to expand its definition of financial risk to include the investment risk borne by providers who participate in APMs, and to develop a method to capture and quantify such risk,” wrote AHA Executive Vice President Tom Nickels. „We also urge the agency to update existing models, such as the Bundled Payments for Care Initiative and the [Comprehensive Care for Joint Replacement Initiative], so that those models would qualify as advanced APMs.” Among other changes, AHA urged that the Merit-based Incentive Payment System allow hospital-based physicians to use their hospital’s performance on CMS hospital quality reporting and pay-for-performance programs; incorporate socioeconomic adjustment; and align its advancing care information performance category with the hospital meaningful use program. AHA also voiced support for a number of the rule’s proposed flexibilities, and urged the agency to monitor the field’s readiness and consider additional flexibility in the timeline and other requirements.
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HHS announces $20 million for MACRA technical assistance program
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The Department of Health and Human Services will award $20 million to help eligible clinicians in small practices transition to the Quality Payment Program, especially those in rural, medically underserved and health professional shortage areas. Eligible applicants include entities such as quality improvement organizations, regional extension centers and regional health collaboratives. Proposals are due July 28. For more, see the funding announcement. The Medicare Access and CHIP Reauthorization Act of 2015 authorized $100 million over five years for the Direct Technical Assistance program.
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HHS proposes hospital VBP change, other actions to combat opioid epidemic
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Starting in fiscal year 2018, the Centers for Medicare & Medicaid Services (CMS) proposes to no longer use the results from three pain management questions in the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey in determining hospitals’ value-based purchasing program scores, the agency said in the outpatient prospective payment system proposed rule for calendar year 2017. CMS would continue to collect and publicly report the results of the HCAHPS pain management questions, however. AHA has urged CMS to suspend the pain-related questions in the VBP program while the agency works to address concerns that the questions may create pressure to prescribe opioids. CMS also is field testing alternative pain management questions, which could be incorporated into the HCAHPS survey through future rulemaking. In addition, CMS recently issued a final rule that would allow qualified practitioners to request approval to treat up to 275 patients a year with buprenorphine if they have maintained an active waiver to treat up to 100 patients for a year and meet other criteria described in the rule. That’s up from an originally proposed 200 patients a year. Buprenorphine, a controlled substance, is one of three drugs approved by the Food and Drug Administration for medication-assisted treatment of opioid dependence. Among other actions, the Department of Health and Human Services issued a request for information on the most promising approaches in prescriber education and training programs and effective ways to leverage HHS programs to implement or expand them.
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CDC issues preparedness plan for locally acquired Zika cases
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The Centers for Disease Control and Prevention recently issued an interim plan for responding to locally acquired cases of Zika virus infection in the continental U.S. and Hawaii. As of June 15, only travel-associated cases have been reported in the continental U.S., including three infants born with birth defects and three pregnancy losses in U.S. states. The response plan outlines state and CDC activities to prevent and reduce local transmission once it has been identified. According to CDC, Zika infections appear to be increasing rapidly in Puerto Rico, based on a 1.1 percent infection rate among local blood donations in the week ending June 11. The territory has screened all local blood donations for Zika since April using a highly accurate test. In areas without active Zika virus transmission, the Food and Drug Administration recommends deferring from blood donation people who have had Zika-like symptoms in the past four weeks; sexual contact with someone who has traveled to or lived in an area with active Zika virus transmission in the past three months; or traveled to areas with active transmission in the past four weeks.
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Study: Medicare ACOs associated with modest reduction in spending for hospital care
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Medicare accountable care organizations (ACOs) are associated with modest reductions in spending and use of hospitals and emergency departments, according to a study published recently by JAMA Internal Medicine. The study compared changes in spending and usage for beneficiaries cared for by ACO physicians and non-ACO physicians between January 2009 and 2013, including a subgroup of clinically vulnerable beneficiaries. After ACO contract implementation, quarterly spending per beneficiary decreased by $34 in the study’s overall Medicare population and $114 in the clinically vulnerable population, which included patients with conditions such as diabetes, coronary artery disease and congestive heart failure.
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The impact of physicians on patient satisfaction
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Hospitals and their boards must look beyond patient satisfaction scores and consider the factors that influence them, specifically the role of the physician, says Derek K. King, MD in his article, „The Physician’s Impact on Patient Satisfaction.” The article appears in the summer 2016 issue of AHA’s Great Boards newsletter. Physicians are an integral and increasingly important part of the overall enterprise, King writes, and their satisfaction will help drive success on a number of metrics, including patient satisfaction. The article includes six questions hospital boards and leaders should consider in assessing physician satisfaction, such as their work/life balance and the input physicians have in decision making.
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More specialists open to hospitalist work
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More graduating physicians (residents and fellows) are open to working as a hospitalist, according to a recent article from HealthLeaders Media. The article cites statistics from Profiles, a physician recruiting database, which asked graduating physicians about their career goals and specialty choices and found that almost 50 percent were open to the idea of a hospitalist position. Although alluring to physicians, hospitalists can present cultural and recruiting challenges for organizations, the article says. For example, the loss of autonomy for hospitalists can be difficult to handle, the article mentions, and the paradigm shift in how patients are cared for in the hospital will take time to adjust to.
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How an electronic nudge can help physicians with patient care
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Is there a way to help doctors make the correct diagnosis, choose the right treatment or follow up on worrisome tests? According to a recent article from the Wall Street Journal there is – compare them to their peers. The article cites research from Dr. Jeffrey Linder, an internist, director of the Primary Care Practice Based Research at Brigham and Women’s Hospital in Boston, and an associate professor at Harvard Medical School, whose studies on antibiotic overprescribing has found physicians do respond to electronic nudges and feedback about what they are doing, especially when they are compared to their peers. For such electronic interventions to work, the article says they have to be carefully designed, especially with accurate data and timing.
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New webinar to focus on one community’s response to the opiate epidemic
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Join us for a webinar highlighting one community’s response to the opioid epidemic. This interactive session will be held July 22, 2016 at 2:30 p.m. Eastern for one hour.
Hear from Oregon Health & Science University (OHSU) Chief Integration Officer, Tom Yackel, MD and Assistant Professor of Medicine and Associate Program Director, Addiction Medicine Fellowship, Melissa Weimer, DO, MCR about the three-county collaborative involving 14 hospitals from four health systems, two community care organizations and four health departments that have developed a community standard to reduce the use of and addiction to opiates.
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Early bird rates expire this Sunday: Register now for CHG’s fall symposium
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The Center for Healthcare Governance (CHG) presents its fall symposium on leading and governing health care organizations, Sept. 18-20, 2016 at the Hyatt Regency Boston, Boston, MA.
Take advantage of CHG’s new pricing to enable board member participation. REGISTER by July 10 for the greatest savings.
In this timely program, trustees and executive leadership will gain insights into the trends that are transforming the delivery system and learn strategies and tools for navigating an increasingly complex environment. Industry experts will offer analyses of the contextual issues framing the health care environment. Small group interactive sessions will explore the board’s responsibility to oversee critically important issues such as executive compensation, succession planning, credentialing and quality improvement.
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FEATURED RESOURCE
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The State of the Behavioral Health Workforce: A Literature Review
For more resources, visit our website.
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MOST POPULAR
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The most popular article from our last issue:
AMA issues updated medical ethics code, guidance for ethical practice in telemedicine
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The American Hospital Association’s
Physician Leadership Forum
155 N. Wacker Drive, Suite 400
Chicago, IL 60606
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