CMS releases proposed 2017 physician payment rule
|
The Centers for Medicare & Medicaid Services (CMS) has issued its proposed rule for the physician fee schedule for calendar year 2017. After application of the 0.5 percent payment increase required by the Medicare Access and CHIP Reauthorization Act of 2015 and other budget neutrality cuts, CMS estimates a 0.08 percent decrease in physician payment rates for 2017 compared to 2016. In addition, CMS proposes to pay for new telehealth services, including end-stage renal disease-related services for dialysis, advance care planning services, and critical care consultations, and to expand the Center for Medicare & Medicaid Innovation Diabetes Prevention Program model. The agency also proposes a number of new codes to more accurately pay for primary care, care management and other cognitive specialties, including separate payments to primary care practices that use interprofessional care management resources to treat patients with behavioral health conditions. With respect to Medicare Advantage, CMS proposes to require health care providers and suppliers to be screened and enrolled in Medicare in order to contract with and provide items and services through a MA organization. The agency also proposes to release two new sets of data related to MA and Part D prescription drug plans: one including information on the bids that MA plans submit, which reflect their estimated costs of providing benefits to enrollees, and another including information on MA and drug plans’ medical-loss ratios. Other proposals include changes to the quality measurement requirements of the Medicare Shared Savings Program (MSSP), including revisions to the measure set, data validation process and scoring methodology; a change to allow individual eligible professionals participating in MSSP to report quality data separately for the purposes of the Physician Quality Reporting System (PQRS), and to have that data used in PQRS in the event the MSSP ACO fails to report quality data; and updates to the informal review process used in the physician value modifier program. The proposed rule was published in the July 15 Federal Register, and comments are due Sept. 6.
|
|
|
Partnership to transform clinical training selects hospital/medical school participants
|
Six hospitals and two medical schools have been selected to participate in a four-year initiative, in partnership with the American Hospital Association (AHA) and others, to transform clinical training for residents and physicians who pursue formal specialty and subspecialty training, the Accreditation Council for Graduate Medical Education (ACGME) recently announced. The organizations are: Children’s National Medical Center, Washington, D.C.; Cleveland Clinic Foundation; Maine Medical Center, Portland; Our Lady of the Lake Regional Medical Center, Baton Rouge, LA; Strong Memorial Hospital of the University of Rochester; The University of Texas at Austin Dell Medical School; University of California, San Francisco School of Medicine; and University of Chicago Medical Center. The ACGME will provide up to $75,000 per year to each organization, which they are expected to match. The Pursuing Excellence in Clinical Learning Environments initiative grew out of ACGME’s Clinical Learning Environment Review (CLER) Program.
|
|
|
ACGME issues report on CLER findings
|
The Accreditation Council for Graduate Medical Education (ACGME) has released the first in a series of reports on the ACGME’s recent National Report of Findings. The report summarizes both quantitative and qualitative data about graduate medical education collected from 297 site visits across the country through the Clinical Learning Environment Review (CLER) Program. The executive summary provides an overview of this important initiative and outlines valuable key findings for teaching hospitals and medical centers.
The AHA’s Physician Leadership Forum and ACGME will co-host a free webinar on the CLER Program July 25 at 2:00 p.m. ET. Kevin B. Weiss, MD, MPH will discuss the purpose of the CLER program, share key themes, and data from the National Report of Findings 2016. John R. Combes, MD will share his perspective on how the CLER focus and process are providing teaching hospitals an important opportunity to examine and reimagine their care environments. To register, click here.
|
|
|
AHA shares MACRA proposed rule concerns with Senate committee
|
The Senate Finance Committee recently held a hearing to examine how the Centers for Medicare & Medicaid Services (CMS) proposes to implement physician payment reforms under the Medicare Access and CHIP Reauthorization Act (MACRA) of 2015. In a statement submitted to the committee, AHA said it supports a number of policies in the agency’s recent proposed rule for the physician quality payment program but significant changes are needed. Specifically, AHA said the program should include an expanded definition of advanced alternative payment models (APM) that recognizes the substantial investments needed to launch and operate APM arrangements. It also called for a quality and resource use measure reporting option in which hospital-based physicians can use CMS hospital quality program measure performance in the Merit-based Incentive Payment System (MIPS). In addition, AHA said the program should include a socioeconomic adjustment in the calculation of performance as needed; and alignment between the hospital meaningful use program and the advancing care information (ACI) category of the MIPS, and simplified ACI requirements. AHA also urged Congress to consider changes to the fraud and abuse laws „to allow hospitals and physicians to work together to achieve the important goals of new payment models – improving quality, outcomes and efficiency in the delivery of patient care.”
|
|
|
Hospital leaders urge Congress to remove legal barriers to health care transformation
|
The Senate Finance Committee recently held a hearing on ways to improve and reform the Stark physician self-referral law. Witnesses unanimously recommended that the compensation portion of the Stark law be removed. „The Stark Law imposes substantial limits on a hospital’s ability to participate in innovative payment arrangements with physicians,” said Peter Mancino, deputy general counsel for the Johns Hopkins Health System. Ronald Paulus, MD, president and CEO of Mission Health in Asheville, NC, said the law „sets up barriers to the necessary alignment between hospitals and physicians that is absolutely essential to transform our delivery system. Because of the extraordinary penalties involved, it often „freezes” health systems in place and absolutely impairs patient care, performance improvement and the shift to value-based payment…Only Congress can remove those barriers.” In a statement and report submitted to the committee, AHA said the Stark Law „should be reformed to focus exclusively on ownership arrangements.” Compensation arrangements „should be subject to oversight solely under the Anti-Kickback Law,” AHA said and urged Congress to „create a clear and comprehensive safe harbor under the Anti-Kickback Law for arrangements designed to foster collaboration in the delivery of health care and incentivize and reward efficiencies and improvements in care.”
|
|
|
The Joint Commission announces new antimicrobial stewardship standard
|
The Joint Commission recently announced a new Medication Management (MM) standard for hospitals, critical access hospitals, and nursing care centers which addresses antimicrobial stewardship.
This standard was developed following the White House Forum on Antibiotic Stewardship, held on June 2, 2015. At the forum, The Joint Commission joined major health care organizations, food companies, retailers, and animal health organizations at the forum to express commitment for implementing changes over the next five years to slow the emergence of antibiotic-resistant bacteria, detect resistant strains, preserve the efficacy of existing antibiotics, and prevent the spread of resistant infections.
|
|
|
CDC awards $26 million to prevent health care-associated, antibiotic-resistant infections
|
The Centers for Disease Control and Prevention (CDC) has awarded $26 million in grants through 2020 to five academic medical centers conducting research to prevent health care-associated and antibiotic-resistant infections as part of the agency’s Prevention Epicenters Program. The recipients are: Chicago Prevention and Intervention Epicenter at Rush University and Cook County Health and Hospitals System; Duke University and the University of North Carolina; The Harvard Pilgrim Health Care and University of California, Irvine; The University of Pennsylvania; and Washington University School of Medicine in St. Louis and BJC Healthcare Prevention Epicenter. The funding is part of CDC’s Antibiotic Resistance Solutions initiative. The Chicago Epicenter also received $4.45 million from CDC’s Safety and Healthcare Evaluation and Research Development contract to develop and test regional approaches for preventing transmission of antibiotic-resistant germs between health care facilities. „For nearly two decades, the Epicenters have advanced the fight against healthcare-associated infections with practical clinical innovations that have saved lives,” said CDC Director Tom Frieden, MD. „Antibiotic-resistant infections are on the rise, making this research even more critical today than ever.”
|
|
|
AHA names chief medical officer, president and CEO of HRET
|
Jay Bhatt, DO, will join the American Hospital Association (AHA) in September as chief medical officer and president and CEO of the Health Research & Educational Trust (HRET), overseeing the association’s clinical leadership and health activities. Bhatt will lead the AHA’s quality activities in several areas, including HRET, the Institute for Diversity in Health Management and Association for Health Improvement. He also will direct physician engagement activities and provide leadership on policy issues. Bhatt is currently the chief health officer for the Illinois Health and Hospital Association. He oversees its Institute for Innovations in Care and Quality, and he is president of the Midwest Alliance for Patient Safety. „Jay has been a leader in efforts to improve quality and patient safety, and a real innovator in transforming health care,” said AHA President and CEO Rick Pollack. „We’re excited to have him join us, and know he will make valuable contributions to the AHA and the entire health care field.”
|
|
|
|
FEATURED RESOURCE
|
Verification of Graduate Medical Education
For more resources, visit our website.
|
|
|
|
|
|
|
MOST POPULAR
|
The most popular article from our last issue:
The impact of physicians on patient satisfaction
Full story
|
|
|
|
|
