Physician Editor

Just for level setting, value=quality/cost. Unfortunately, physician payment structure still rewards volume over quality, hence the continued rising cost, and lack of improvement in the value proposition.

Although most physicians believe that the current structure does not adequately financially reward providers for quality, only 1/3 support public reporting.

A pertinent quotation: “If the MDs don’t develop quality measures, the MBAs will.”

The PQRS program is currently elective, with nominal payment incentives, but will become a negative incentive for non-participating providers in 2015. The next step will be the physician feedback program (known as PRUR), which will evolve into the VBP program by physician. Similar to the hospital VBP program, it will be budget neutral, and will be piloted in selected physician groups in 4 states, then rolled out to all physicians in 2017.

Key takeaways for Hospitalists:

• CMMS is moving from public reporting → pay for VALUE performance, for all physicians, through the PQRS → PRUR → VBP programs.
• All physicians need to familiarize themselves with the data and the attribution models.
• All physicians need to gain QI skills to improve their performance metrics.

Just for level setting, value=quality/cost. Unfortunately, physician payment structure still rewards volume over quality, hence the continued rising cost, and lack of improvement in the value proposition.

Although most physicians believe that the current structure does not adequately financially reward providers for quality, only 1/3 support public reporting.

A pertinent quotation: “If the MDs don’t develop quality measures, the MBAs will.”

The PQRS program is currently elective, with nominal payment incentives, but will become a negative incentive for non-participating providers in 2015. The next step will be the physician feedback program (known as PRUR), which will evolve into the VBP program by physician. Similar to the hospital VBP program, it will be budget neutral, and will be piloted in selected physician groups in 4 states, then rolled out to all physicians in 2017.

Key takeaways for Hospitalists:

• CMMS is moving from public reporting → pay for VALUE performance, for all physicians, through the PQRS → PRUR → VBP programs.
• All physicians need to familiarize themselves with the data and the attribution models.
• All physicians need to gain QI skills to improve their performance metrics.

Just for level setting, value=quality/cost. Unfortunately, physician payment structure still rewards volume over quality, hence the continued rising cost, and lack of improvement in the value proposition.

Although most physicians believe that the current structure does not adequately financially reward providers for quality, only 1/3 support public reporting.

A pertinent quotation: “If the MDs don’t develop quality measures, the MBAs will.”

The PQRS program is currently elective, with nominal payment incentives, but will become a negative incentive for non-participating providers in 2015. The next step will be the physician feedback program (known as PRUR), which will evolve into the VBP program by physician. Similar to the hospital VBP program, it will be budget neutral, and will be piloted in selected physician groups in 4 states, then rolled out to all physicians in 2017.

Key takeaways for Hospitalists:

• CMMS is moving from public reporting → pay for VALUE performance, for all physicians, through the PQRS → PRUR → VBP programs.
• All physicians need to familiarize themselves with the data and the attribution models.
• All physicians need to gain QI skills to improve their performance metrics.

We now have, in effect, a parliamentary system, with no overlap between democrats and republicans, which is it is rooted in a system that does accept a parliamentary system, said Ornstein.  This is playing out as “utterly dysfunctional.” This “tribalism” has extended out many states, and the Supreme Court, with innumerable controversial 5-4 decisions.

Bottom Line

• The chasm between republicans and democrats is wider than ever

• This is spilling out to states and the Supreme Court

• Fasten your seatbelts as the coming months will be tumultuous

• But business is booming for political analysts!

We now have, in effect, a parliamentary system, with no overlap between democrats and republicans, which is it is rooted in a system that does accept a parliamentary system, said Ornstein.  This is playing out as “utterly dysfunctional.” This “tribalism” has extended out many states, and the Supreme Court, with innumerable controversial 5-4 decisions.

Bottom Line

• The chasm between republicans and democrats is wider than ever

• This is spilling out to states and the Supreme Court

• Fasten your seatbelts as the coming months will be tumultuous

• But business is booming for political analysts!

We now have, in effect, a parliamentary system, with no overlap between democrats and republicans, which is it is rooted in a system that does accept a parliamentary system, said Ornstein.  This is playing out as “utterly dysfunctional.” This “tribalism” has extended out many states, and the Supreme Court, with innumerable controversial 5-4 decisions.

Bottom Line

• The chasm between republicans and democrats is wider than ever

• This is spilling out to states and the Supreme Court

• Fasten your seatbelts as the coming months will be tumultuous

• But business is booming for political analysts!

CMS has evolved from a passive payor to an active facilitator and catalyst for quality improvement, with a “relentless focus” on what is the right thing to do for patients, Pat Conway told more than 2,000 hospitalists at HM12 in San Diego this morning.

There are a myriad of efficiencies and tactics being implemented at CMS to enhance the ability to roll out best practices across the board, in rapid cycle sequence. The future of safety is moving from individual safety breaches to an “all-cause harm” metric that tracks across setting.

A big focus in the next 2 years will be reduction of readmission (with financial penalties) and a reduction of hospital-acquired conditions (through the Partnership for Patients).

CMS is moving toward:

• Patient-centered outcomes;
• Reducing burdensome measurements; and
• Anticipating and mitigating unintended consequences;

Send your comments and feedback to: patrick.conway@cms.hhs.gov

CMS has evolved from a passive payor to an active facilitator and catalyst for quality improvement, with a “relentless focus” on what is the right thing to do for patients, Pat Conway told more than 2,000 hospitalists at HM12 in San Diego this morning.

There are a myriad of efficiencies and tactics being implemented at CMS to enhance the ability to roll out best practices across the board, in rapid cycle sequence. The future of safety is moving from individual safety breaches to an “all-cause harm” metric that tracks across setting.

A big focus in the next 2 years will be reduction of readmission (with financial penalties) and a reduction of hospital-acquired conditions (through the Partnership for Patients).

CMS is moving toward:

• Patient-centered outcomes;
• Reducing burdensome measurements; and
• Anticipating and mitigating unintended consequences;

Send your comments and feedback to: patrick.conway@cms.hhs.gov

CMS has evolved from a passive payor to an active facilitator and catalyst for quality improvement, with a “relentless focus” on what is the right thing to do for patients, Pat Conway told more than 2,000 hospitalists at HM12 in San Diego this morning.

There are a myriad of efficiencies and tactics being implemented at CMS to enhance the ability to roll out best practices across the board, in rapid cycle sequence. The future of safety is moving from individual safety breaches to an “all-cause harm” metric that tracks across setting.

A big focus in the next 2 years will be reduction of readmission (with financial penalties) and a reduction of hospital-acquired conditions (through the Partnership for Patients).

CMS is moving toward:

• Patient-centered outcomes;
• Reducing burdensome measurements; and
• Anticipating and mitigating unintended consequences;

Send your comments and feedback to: patrick.conway@cms.hhs.gov