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From The Consultant’s Corner 5/5/16

May 5, 2016 News No Comments

How to Align Physician Compensation with Value-Based Care

The move from volume-based to value-based reimbursement models is undeniable. Care quality, clinical outcomes, patient satisfaction, and cost containment all will play increasingly larger roles in reimbursement over the next few years. However, the pace at which this change is occurring varies significantly from payer to payer. Not all payers are moving simultaneously.

CMS has taken the lead with initiatives such as the Physician Quality Reporting System, the Value-based Payment Modifier, and the upcoming Merit-based Incentive Payment System (MIPS). While some commercial payers are following CMS closely, others have committed themselves to evolving their own value-based programs.

In the midst of this flux, practices face the difficult task of retaining some focus on volume to remain financially viable while the industry transitions. What this means from a practical perspective is that practices can no longer use past compensation plans as a model for the future. In fact, they can’t expect to nail down a physician compensation plan today that will last for even the next three years; physician compensation models must progress with the industry.

Flexibility is Key

Compensation plans developed today need to allow for flexibility, so they can accommodate current productivity requirements while supporting a changing culture and incentivizing the behaviors necessary for success over the long term. One way to achieve flexibility involves the periodic evaluation of payer progress toward value-based reimbursement.

The degree to which a practice accelerates its value-based physician payment model should mirror the practice’s payer mix. Over time, the percentage of overall compensation tied to value-based incentives should increase to align with the percentage of overall reimbursement tied to value-based programs.

The task now is to prepare for — or align with — those new reimbursement incentives. Practices must start turning away from their historic focus on independence and production, and toward a new focus on collaboration, communication, and overall outcomes and cost. By setting the right foundation, practices can ensure that their provider compensation packages accurately reflect their emerging quality, outcomes, cost, and patient satisfaction goals. It’s a significant opportunity to create compensation models that support the dramatic culture shift necessary to achieve value-based care.

Set a Value-Based Foundation

Practice and health system governance frameworks range widely, and include any number of different employment or contract agreements. While the governance model will affect how a practice implements its value-based physician compensation plan — for example, its physician engagement, design, timeline, and communication strategies — it shouldn’t affect the compensation plan’s basic structure. No matter the governance model, all value-based physician compensation plans must incentivize care quality, patient outcomes, and the patient experience. The reason is simple: These factors lie at the center of value-based care delivery. Primary care providers are also part of the nucleus.

Achieving value-based care requires someone — predominately primary care providers — to coordinate care among patients, internal staff, hospitalists, and specialists. That takes time, which fee-for-service models have seldom reimbursed. In comparison, value-based financial incentives should encourage providers to spend time on those care coordination activities and preventive measures that result in favorable patient outcomes. Typically, this kind of compensation plan is structured as base salary (often determined by years of experience) plus incentives for factors such as:

  • Care quality —Practices can use HEDIS, PQRS, Meaningful Use, and other existing quality metrics to measure and incentivize physician quality. Care coordination is another essential component of quality.
  • Patient access — Ensuring patients are seen in a timely manner helps improve outcomes and reduce costs. Strong access capabilities may also play a role not only in lowering cost, but in satisfying patients.
  • Patient satisfaction — Patient communication, education, and engagement activities can increase satisfaction, as well as improve care plan compliance. (Plus, better compliance could result in improved outcomes and decreased costs.) Practices can use existing satisfaction surveys to measure and incentivize physicians for their patient engagement efforts.
  • Corporate citizenship — Practices can further incentivize physicians to follow evidence-based clinical protocols.
  • Productivity — Productivity will not entirely disappear as an element of compensation plans, but should take a different shape. For example, practices should ensure that physician panel sizes are appropriate to their care coordination and management responsibilities.

Smooth the Transition

Traditionally, most value-based factors have been difficult to manage and control. However, the adoption of EHRs and CMS quality programs such as PQRS and MU have established a means for data capture, decision support, and reporting. Consequently, practices now have a good foundation on which to build physician compensation plans that align with the core tenets of value-based care. Still, it won’t happen overnight. Over the next few years, those practices with the flexibility to evolve alongside their payers are most likely to experience the smoothest — and most rewarding — transitions.

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Brad Boyd is president of Culbert Healthcare Solutions.


Contacts

JenniferMr. H, Lorre, Dr. Jayne, Dr. Gregg

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News 5/5/16

May 5, 2016 News No Comments

Top News

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Hill Ferguson (PayPal) joins Doctor on Demand as CEO. Ferguson will take over from Adam Jackson, who helped found the business in 2013. The CEO shuffle will purportedly help Doctor on Demand maintain its direct-to-consumer business and rapidly expand its enterprise clientele. Jackson, who interned for Ferguson while at Vanderbilt University, shared these parting words in a blog post: “… I have realized that I am an entrepreneur at heart, and our team’s staggering achievements to date have led us to a growth phase that I believe calls for a different set of talents in a CEO.”


Webinars

May 11 (Wednesday) noon ET. “Measuring the Impact of ACA on Providers.” Sponsored by Athenahealth. Presenters: Dan Haley, general counsel, Athenahealth; Josh Gray, VP, AthenaResearch. Athenahealth will share the findings of real-time analysis of its provider network. The presenters will describe how patient financial obligations have changed, how physician reimbursement is trending, the patterns created by increased ACA coverage, and the effect of the latest ACA trends on physician practices.

Contact Lorre for webinar services. Past webinars are on our HIStalk webinars YouTube channel.


Acquisitions, Funding, Business, and Stock

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Forbes makes the case for a primary care renaissance, citing the $1.2 billion that has been recently pumped into companies looking to reinvigorate the space. Author Dave Chase calls out companies like Zoom+ in Portland and Privia Health in Arlington, VA as part of the “the next-generation value-based primary care models at the heart of the DIY health reform movement.” Privia, which has scaled to over 3 million patients in the Washington, DC area over the last two years, seems to be well on its way to becoming a population health management success story.


Announcements and Implementations

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The Healthcare Administrative Technology Association announces that 12 new members have joined in the last several months, including Azalea Health, EProvider Solutions, MGMA, and Office Ally.

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Not to be outdone, CommonWell announces 11 new members have joined since HIMSS.

McKesson Specialty Health develops a set of solutions to support oncology practices participating in the CMS Oncology Care Model, which launches July 1. The new solution suite, which has undergone pilot testing at US Oncology Network facilities, includes professional services; EHR, RCM, and analytics technology, and patient engagement tools.

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Chatterbox Pediatric Therapy Center (ID) selects Mediware’s MediLinks 2016 outpatient rehabilitation therapy software for its 26 therapists.

August Public Schools in Augusta, KS will implement an EHR from CareDox to help its school nurses care for 2,300 students across six schools. Launched in 2014, New York City-based CareDox secured $2.8 million in seed funding last month, bringing its total raised to $6.9 million.

Advanced Data Systems adds chronic care management technology from CareSync to its Medics EHR software.


People

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Halle Tecco tweets that she’s stepping down as managing director of Rock Health. Tecco helped co-found the organization in 2010, when it was primarily an accelerator program. It has now attempted to make the leap to seed investor, funding companies like Doctor on Demand, Augmedix, and Omada Health.


Telemedicine

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The Medical Society of Northern Virginia offers its members access to DoctorsTelemed services from CloudVisit.


Other

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File this under Finger Lickin’ Good (or Gross): KFC develops nail polish that tastes like fried chicken to boost brand awareness in Hong Kong. The polish is available in two shades – Original Recipe and Hot & Spicy.


Contacts

JenniferMr. H, Lorre, Dr. Jayne, Dr. Gregg

More news: HIStalk, HIStalk Connect.

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JennHIStalk

News 5/4/16

May 4, 2016 News No Comments

Top News

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Private equity firm Warburg Pincus acquires DocuTap for an undisclosed sum. Founded in 2000, the South Dakota-based company offers EHR, PM, and RCM software for primary and urgent care practices. It has raised $30 million in private equity over the last three years, adding 350 urgent care clinics in the last year alone. Founder and CEO Eric McDonald hopes the sale will help DocuTap expand its offerings to pediatric and more primary care physicians. “For DocuTap, the clients, the team, this is nothing but good news,” McDonald said. “They’re not moving the headquarters. They’re excited to get behind the leadership team, and they love the Sioux Falls community, so there aren’t any concerns on anybody’s part of downsizing or shifting gears.”


Webinars

May 5 (Thursday) 2:00 ET. “Reducing CAUTI and Improving Early Sepsis Detection Through Clinical Process Measurement.” Sponsored by LogicStream. Presenters: Jen Biltoft, director of quality improvement, SCL Health; Marla Bare, EHR architect, SCL Health. This webinar will describe how SCL Health reduced catheter-associated urinary tract infections by 30 percent in just three months through clinical process measurement. The SCL Health presenters will also share their plans for applying a similar process to the early detection of sepsis.

May 11 (Wednesday) noon ET. “Measuring the Impact of ACA on Providers.” Sponsored by Athenahealth. Presenters: Dan Haley, general counsel, Athenahealth; Josh Gray, VP, AthenaResearch. Athenahealth will share the findings of real-time analysis of its provider network. The presenters will describe how patient financial obligations have changed, how physician reimbursement is trending, the patterns created by increased ACA coverage, and the effect of the latest ACA trends on physician practices.

Contact Lorre for webinar services. Past webinars are on our HIStalk webinars YouTube channel.


People

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Debra Mathias joins Freed Associates as a consultant.

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Apple hires Yoky Matsuoka, a co-founder of Google’s X lab and most recently head of technology at Nest, which Google acquired in 2014. Matsuoka will work on several health-related projects at Apple, including HealthKit, ResearchKit, and CareKit. She seems to be a true Renaissance woman: Injury waylaid her plans to become a tennis star, so she decided to pursue neurorobotics, for which she won a MacArthur Foundation “genius” grant in 2007.


Announcements and Implementations

Medical Center Radiologists (VA) renews its agreement with Zotec Partners for RCM services.


Telemedicine

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Marijuana Company of America begins offering virtual medical marijuana consults from Hello.MD to members of its Club Harmoneous subsidiary.

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MyTelemedicine.com relocates and expands into new offices in McKinney, TX. The company which was founded in 2014 by former AmeriDoc CMO Rey Colon, is also enhancing its 24-hour call center for provider and employer clients.

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Philadelphia-based Tandigm Health, a primary care-focused joint venture between DaVita HealthCare Partners and Independence Blue Cross, partners with TouchCare to offer virtual consults to its network of 380 physicians.

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In related news, Durham, NC-based TouchCare adds a check-in feature to its mobile app.

Healthx adds Teladoc services to its member services platform for payers.


Research and Innovation

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A study in JAMA Dermatology finds that giving Medicaid patients access to virtual dermatology visits sharply increases the use of those services. Researchers saw the number of patients who received care from a dermatologist nearly double after the introduction of teladermatology services. Those services were used primarily by younger, healthier patients for less-severe skin conditions like warts and acne. The findings almost beg the question, “Did the increased use result simply from availability, or because the services were genuinely needed?”

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A survey of 500 patients reveals that just 22 percent use access to their EHR to make healthcare decisions, despite the fact that 60 percent have access to them. The majority of respondents access their EHRs to simply stay informed, indicating there is an actionable gap between hard health data and a patient’s willingness to act upon it. The gap highlights the challenge that providers have had with patient engagement since MU attempted to incentivize it – you can lead a horse to water, but you can’t make it drink unless you explain how the act of drinking will benefit it (and you).


Other

Eternal Sunshine of the Spotless Mind, part two: The New Republic tells the fascinating tale of University of Amsterdam Professor of Clinical Psychology Merel Kindt and her development of a treatment that can “neutralize” fearful memories with a pill traditionally used to treat heart disease.


Sponsor Updates

  • AdvancedMD releases a new ebook, “Advanced Practice Training: Changing the Game in Financial Reporting.”
  • Aprima will exhibit at the ACP Internal Medicine Meeting 2016 May 5-7 in Washington, DC.
  • KLAS recognizes Nordic’s Epic implementation support and staffing services, also ranking the company for the first time in the IT Advisory segment with a 92.6 score.
  • EClinicalWorks will exhibit at the IMGMA Spring Conference May 5-6 in Indianapolis.
  • Healthwise will exhibit at the EClinicalWorks 2016 Health Center Summit May 11-13 in Boston.

Blog Posts


Contacts

JenniferMr. H, Lorre, Dr. Jayne, Dr. Gregg

More news: HIStalk, HIStalk Connect.

Get HIStalk Practice updates.
Contact us online.
Become a sponsor.

JennHIStalk

News 5/3/16

May 3, 2016 News No Comments

Top News

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Health IT and management services company DAS Health acquires the EHR and PM business of Jackson Key Practice Solutions. It’s the third acquisition for the Tampa, FL-based company in the past seven months. The company acquired Spectra Healthcare’s RCM portfolio last October, and ConXit Technology Group in January.


HIStalk Practice Announcements and Requests

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Do yourself a favor and check out Dr. Gregg’s latest DOCtalk, “This is What Happens When MACRA.” He definitely gives ZDogg a run for his money.


Webinars

May 5 (Thursday) 2:00 ET. “Reducing CAUTI and Improving Early Sepsis Detection Through Clinical Process Measurement.” Sponsored by LogicStream. Presenters: Jen Biltoft, director of quality improvement, SCL Health; Marla Bare, EHR architect, SCL Health. This webinar will describe how SCL Health reduced catheter-associated urinary tract infections by 30 percent in just three months through clinical process measurement. The SCL Health presenters will also share their plans for applying a similar process to the early detection of sepsis.

Contact Lorre for webinar services. Past webinars are on our HIStalk webinars YouTube channel.


Announcements and Implementations

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SuperCoder launches the online HIPAA Institute to help physician practices better understand HIPAA’s privacy, security, and data breach requirements.

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Physical Therapy Innovations (CA) upgrades its three facilities to Clinicient’s Total Insight automated clinical, financial, and RCM solution.

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National advocacy organization Young People in Recovery joins MAP Health Management’s MAP Recovery Network. As part of the network, YPR will offer its chapters access to MAP’s population health management solutions to collect, measure, and demonstrate addiction-treatment data.

The National Association for Trusted Exchange (NATE) and CommonWell Health Alliance become members of each other’s organizations.

PerfectByte adds flat rate credit card processing to its practice management software for physician, dental, and orthodontic practices.

Transitional care management app vendor Phyzit joins the Athenahealth More Disruption Please online marketplace.


People

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Glen Golemi (UnitedHealthcare) joins EQHealth Solutions as president and CEO.

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Arkansas Surgeon General Greg Bledsoe, MD joins Phyzit’s advisory board and becomes an equity owner of the company. 


Government and Politics

CMS keeps the MACRA and MIPS resources coming with the MIPS Mobile Challenge. The competition will encourage developers to design a website or app that will give physicians real-time information on the new program – not to mention entice potentially 1.2 million eligible physicians to participate in the program. The two-phase competition will award a $25,000 grand prize in mid-October.


Telemedicine

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CMS approves Medicaid reimbursement for virtual consults at FQHCs in Connecticut. The approval comes after the completion of a year-long pilot project across Community Health Center facilities that conducted 1,000 remote consults using Safety Net Connect’s telemedicine platform.


Other

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HIPPA strikes again: The Buffalo Medical Group (NY) launches an investigation into a fraudulent letter sent to several patients stating that they had suffered HIPAA violations at the hands of a chatty BMG nurse who shared confidential patient details with her boyfriend while on the phone. BMG officials realized the letter was most likely fake due to the overzealous use of “HIPPA.”

Smart scales are one thing; front-door locks are something else entirely: Computer scientists discover flaws in Samsung’s Smart Home automation system that let them wage a range of remote attacks, including “picking” connected door locks from any location. They recommend that consumers “think twice before using the system to connect door locks and other security-critical components.” (IoT is beginning to creep me out.)


Contacts

JenniferMr. H, Lorre, Dr. Jayne, Dr. Gregg

More news: HIStalk, HIStalk Connect.

Get HIStalk Practice updates.
Contact us online.
Become a sponsor.

JennHIStalk

DOCtalk with Dr. Gregg 5/3/16

May 3, 2016 News 1 Comment

This is What it Sounds Like When MACRA

Dig if you will the process
Of you and me engaged in healthcare
The sweat of my typing covers me
Can you, my patient
Can you process this?

Dream if you can a system
Of payments and data run smooth
Providers strike curious poses
We feel the heat
Of changes from old MU

How can you just leave us standing?
In constant changes so cold? (So cold)
You’re definitely too demanding
Or maybe I’m just ancient, too old
You certainly aren’t a good mother
You’re never satisfied (You’re never satisfied)
Why can’t we just see our patients?
This is what it sounds like
When MACRA

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Touch if you will my keyboard
Feel how it burns overused
I’ve got arthritis in all my fingers
Don’t make me type more
I sure feel abused

How can you just lead us new ways?
With constant changes untold (Untold)
Think you could be too demanding?
Or maybe I’m just tired, old mold
You certainly aren’t a good mother
You’re never satisfied (You’re never satisfied)
Why can’t we just see our patients?
This is what it sounds like
When MACRA

How can you just leave us hanging?
In management changes so bold? (Changes what’s so bold)
Maybe you’re just a bad steward (Maybe, maybe you’re a too cold)
Maybe I’m just a sad baby, whiny (Ya know I’m whiny)
Maybe you’re just a real “mother” (Maybe you’re just a real “mother”)
You’re never satisfied (You’re never satisfied)
Why can’t we just see our patients? (Can’t we just be, why?)
This is what it sounds like

When MACRA
When MACRA (MACRA, MACRA)
When MACRA (MACRA, MACRA)

Don’t cry (Don’t cry)

When MACRA
When MACRA
When MACRA

When MACRA (MARCA, MACRA, MACRA)

Don’t cry
Doctor, don’t cry
Don’t cry
Don’t cry
Don’t, don’t cry

————————————

Rest in peace, sweet Prince

From the trenches…

“Act your age, not your shoe size.” – Prince

dr gregg

Dr. Gregg Alexander, a grunt in the trenches pediatrician at Madison Pediatrics, is chief medical officer for Health Nuts Media, an HIT and marketing consultant, sits on the board of directors of the Ohio Health Information Partnership, and is the semi-proud author of “Monsters Don’t Fart!


Contacts

JenniferMr. H, Lorre, Dr. Jayne, Dr. Gregg

More news: HIStalk, HIStalk Connect.

Get HIStalk Practice updates.
Contact us online.
Become a sponsor.

JennHIStalk

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