CureMD

What does an optimal revenue cycle management system provide for your practice? In two words… timely reimbursement!

Revenue cycle management (RCM) involves numerous processes and individuals, all (hopefully) working together to ensure that a healthcare provider is adequately and properly reimbursed for services provided. In fact, proper management of the revenue cycle is vital to enhancing revenues received by a health care provider or facility. A denied claim or any other type of lost revenue has a detrimental impact on the financial health of any Healthcare Service provider.

Information is Power

Different studies have shown EMR to have been extremely beneficial to providers and patients while others have shown the use of EMRs to increase the incurred costs drastically. For a doctor looking to implement EMR at the office, reports suggesting varied conclusions can be very confusing.

What is accountable care all about? And who should be held accountable, anyway? Are physicians directly responsible for the outcomes they achieve? What about the money they spend to achieve those outcomes?

We’ve all been hearing about the pros and cons of accountable care for way too long now. Lower costs, better outcomes and improved patient experiences are what it apparently seems to be about. However, I believe we can do better than this.

MACRA is here to improve Medicare by helping physicians focus more on quality care and making patients healthier. By giving physicians new tools, models, and resources the Quality Payment Program ends the Sustainable Growth Rate formula, ensuring that patients get the best possible care. There are two tracks under the program; The Merit-based Incentive Payment System (MIPS) and Advanced Alternative Payment Models (APMs). Find out more on how to stay ahead of the game, here are five of the most helpful resources to keep you updated on MACRA. 

 1)      AMA Releases Value-Based Care, MACRA Resources for Providers

As part of its STEPS Forward program, the American Medical Association (AMA) has released eight new educational modules to support healthcare providers with the transition to value-based care, reported AMA in an official press release.

AMA has developed the online resources for healthcare providers to manage the transition to new value-based reimbursement programs that were proposed in the Department of Health and Human Service’s rulemaking on MACRA implementation.

“With physicians facing critical decisions about new payment models, the AMA is rolling out tools to help practices of all sizes succeed and support better health outcomes for everyone,” said Steven J. Stack, MD AMA President. “The AMA’s new, comprehensive online resources will help physicians drive successful implementation as insurers introduce new payment models that reward better outcomes and treatment coordination.” Read more here

2)      Preparing for MACRA: Top 3 priorities for 2016

Medicare payments for physician services are about to change drastically. The Medicare Access and CHIP Reauthorization Act of 2015 was passed to replace the flawed Medicare Sustainable Growth Rate.

With the recent release of the proposed rule, healthcare organizations are beginning to realize the profound implications of this sweeping legislation. When the final rule is released later this year, eligible clinicians may have only a few months of preparation before the year one reporting period begins on January 1, 2017.

What are MACRA, advanced APMs and MIPS?

What are those preparations? Before we dive into the top three priorities, let's review what MACRA is and why you should care.

MACRA repeals the sustainable growth rate formula, streamlines multiple quality programs (Physician Quality Reporting Program, Value Based Modifier and Meaningful Use) and links the majority of fee for service payments to value and quality. MACRA applies to most clinical providers of Medicare Part B services and establishes two payment tracks – Advanced Alternative Payment Models and the Merit-Based Incentive Payment System. The proposed rule narrowly defines Advanced APMs as downside risk-bearing models such as Medicare Shared Savings Program Track 2 and Track 3, leaving the vast majority of eligible clinicians subject to MIPS. Continue Reading

3)      Healthcare industry reacts to sweeping MACRA proposal, with its big changes for physician IT

The propsed MACRA rule put forth by the U.S. Department of Health and Human Services on Wednesday also holds some pretty big changes for how health IT can be put to work by physicians to drive quality improvement and cost efficiencies.

"By proposing a flexible, rather than a one-size-fits-all program, we are attempting to reflect how doctors and other clinicians deliver care and give them the opportunity to participate in a way that is best for them, their practice and their patients," said Patrick Conway, MD, chief medical officer at the Centers for Medicare & Medicaid Services, in announcing the rule. "Reducing burden and improving how we measure performance supports clinicians in doing what they do best – caring for their patients."

So far, most industry reaction to the notice for proposed rulemaking is positive – recognizing the fact CMS seems to have taken the feedback from more than 6,000 frontline healthcare stakeholders to heart, crafting a rule that's attuned to the needs of physicians. Read more

4)      Physicians have Four Pathways for 2017

Back in July, CMS had hinted at the possibility of a MACRA delay or some restructuring of the proposed rule to decrease the burden of compliance. On September 8, CMS came forward to explain this flexibility. The final ruling is expected to be available in November.

Here is what we know so far:

– The compliance date has not changed. Come January 1, 2017 MACRA changes how CMS pays practices that provide care to Medicare beneficiaries. Physicians can take part via Merit Based Incentive Payment System or Alternative Payment Models. 2017 will be the first reporting year for payment adjustments in 2019.

– CMS has created different levels of participation whereby practices will determine their own level and pace at which they will comply with MACRA. So far, this flexibility only applies to the first year of participation i.e 2017, by 2018 practices are expected to fully comply with MACRA regulations. Continue Reading

Slideshare: http://www.slideshare.net/CureMDHealthcare/mastering-macra-a-beginners-guide-to-new-reimbursement-models

5)      AMA Releases Online Tools to Help Doctors Prepare for MACRA

The Chicago-based American Medical Association has developed several online tools to assist physicians with preparing for and transitioning to pending Medicare payment and delivery changes under the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA).

“MACRA represents the most significant change to Medicare’s physician payment system in a generation, and the AMA is working to help physicians navigate this change and make sure they are prepared for it,” AMA president Andrew Gurman, M.D., said during a conference call with healthcare industry press Oct. 5th.

The new online resources include a payment model evaluator tool, practice-improvement strategies, MACRA-focused podcasts to provide information and guidance during upcoming Medicare changes.

In April 2015, the U.S. Senate passed the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA). In April 2016, the Centers for Medicare & Medicaid Services (CMS) released a notice of proposed rulemaking (NPRM), also known as a “proposed rule,” which sets forth proposed implementation details for MACRA, which CMS has labeled the Quality Payment Program, which includes two paths—the Merit-Based Incentive Payment System (MIPS) and Alternative Payment Models (APMs). In September, CMS announced it will allow physicians to “pick their pace” of participation for the first performance period under MACRA that begins Jan. 1, 2017. Read more

Out-dated EHR bringing your practice down? Or maybe just thinking of switching your practice management software? Look no further. Brining you a basic, 5-step guide to buying the right EHR, this info-graphic is bound to help you choose better and shop smarter. Remember, 59% more buyers are replacing existing EHR Software this year and you most definitely can’t afford staying behind in the race. Analyze, research, consult and go for it! Get the EHR your practice deserves and spend time managing your patients, and not the software. Happy shopping this year! Read more

Identify your billing issues now!

Unless you have zero interaction with digital technology, which is unlikely since you are reading this blog post, you’ve most likely heard about the latest Pokémon Go craze. The new GPS-based augmented reality game is drawing more attention from consumers and the media than even the upcoming Olympic games or presidential election.

Pokémon is an insanely popular franchise that began in Japan and quickly gained popularity in the US in the 1990s. There was a TV show, trading cards, and video games. And now, with this latest app, people are reconnecting with a bit of nostalgia.

How do you Play?

Here’s the long and short of it: the app uses the GPS and camera on your phone to track your real-world locations and augment reality so you can see the little monsters in your world. You might see one in your fridge or sitting next to you on the bus.

The goal of the game is to find ALL of these monsters, capture them and train them so they can eventually do battle with other players’ monsters.

But what does any of this have to do with healthcare? Well, there are those in the healthcare industry who are praising the game for its health benefits, while still others are warning of the dangers.

What, if any, are the possible health benefits of the game?

According to Matt Hoffman, DNP and clinical assistant professor at the Texas A&M College of Nursing, the game is great for public health. “Playing the game is a lot of fun, and it has been a catalyst to get people moving,” said Hoffman who has been affectionately dubbed the “Pokémon Professor” by co-workers.

A current debate in the healthcare industry is whether or not certain technologies are helping or hurting patient satisfaction and outcomes. Inevitably, we want technology to connect and strengthen interactions between doctors and their patients, not get in the way.

When EMRs first came on to the scene, some providers felt they were too clunky and pulled focus from the human being sitting in the exam room. But with the emergence of tablet computing, health and wellness services have been successfully transformed.

iPad EMRs allows mobility and make electronic charting more efficient. But beyond this, they enable doctors and patients to experience a fuller, richer interaction.

1. Better Communication – The Key to Patient Satisfaction

All practices are impacted by whether or not the patients are satisfied, engaged, and believe they are receiving quality care.  According to the 26th Annual HIMSS Leadership Survey, 87% of respondents are making patient satisfaction a top priority for their organizations.

Patients and families appreciate any and all efforts to meet their needs and deliver the information they require.  iPad EMRs let doctors share information much more quickly than was possible in the past. For instance, a few years ago, a doctor would have encouraged her patient to take a pamphlet home containing information about, say, managing diabetes.

Now that same doctor can pull up relevant educational material right on her tablet, including PDFs, videos and audio files. Together, doctor and patient can explore educational material about the disease, which leads to an overall better patient experience.

2. Engaged Patients

As helpful as it is for physicians to share educational material with their patients during appointments, those patients can become overwhelmed and walk out of the office with more questions than they walked in with.

Mobile technology enables patients to go home and review this information again and at their own pace, as well as share it with concerned family members. Beyond this, and perhaps more importantly, mobile technology allows providers to tailor patient education based on their preferred learning style. For example, while older patients may prefer to read PDF documents, younger patients may want to watch educational videos instead. Those with vision problems can listen to content via MP3 files.

CureMD in Spotlight- HIMSS 2016