It’s been well over a year since MACRA of 2015 was passed by Congress and signed into law but according to according to Deloitte’s 2016 Survey of U.S. Physicians, only about 50 percent of practicing physicians have heard of the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA). Interestingly of those 50 percent who have heard of MACRA, the majority have only heard about it but really know nothing about what it is and how it will affect them. We have created a MACRA webinar series to serve as a valuable resource to help your organization prepare now for MACRA.
This webinar is the fourth in our MACRA Webinar Series. Previous webinars include:
•The 411 on Value-Based Reimbursement
•Connecting the dots between PQRS, MIPS, & CAHPS
•MACRA under the lens of a clinically integrated network
In this webinar, Moshe Starkman explores the ins and outs of the MIPS Quality Performance Category. The Quality category accounts for 50 percent of your MIPS composite score in 2017 so there’s no time like the present to begin preparing. In this webinar, Moshe explores:
- The differences between PQRS 2016 and MIPS 2017
- How scoring is done within the Quality category
- How the Quality score impacts the MIPS Composite Performance Score
- Considerations to ensure that you’re getting ready for MACRA
If you’d like to learn more about how we can assist you with your MACRA readiness or how our MIPS Composite Performance Score projection and monitoring tools can help you in the long term, please contact Moshe directly at email@example.com or 801.783.4100.
MACRA is extremely complex and ever evolving — and even though the MACRA guidelines will not be finalized until October 2016 — you really shouldn’t wait until then to begin learning and thinking about the strategic implications for your health care system.
It is our hope that through our MACRA webinar series, you will gain the insight and perspective that will enable you to think deeply and effectively as you prepare for the MACRA changes ahead.
In the third webinar of the series, we welcome Tyler Wilson of Catholic Health Initiatives (CHI) as a panelist. CHI is a nonprofit, faith-based health system operating 105 hospitals in 18 states, and 12 Clinically Integrated Networks (CINs). As the National Director of Clinically Integrated Network Development & Integrity, Tyler supports the development and operations of CHI’s 12 Clinically Integrated Networks (CINs). He is passionate about value-based care delivery and the pursuit of population health as a viable strategy for the future.
In this webinar, we discuss shared savings implementation and risk management as it pertains to the recently passed MACRA legislation.
- What we know about MACRA (as of June 2015)
- CHI and Clinically Integrated Networks (CINs)
- CINs as they pertain to MIPS and/or qualifying as an Advanced APM
- Understanding MACRA preparedness efforts through the lens of Clinically Integrated Networks
- MIPS or MIPS + AAPM? If AAPM, which one and how do we decide?
- How do we prepare for MIPS?
The rate negotiation process can seem like a daunting task. Especially when you feel like your future rests on successful negotiation with your private payer plans. Nevertheless, if you utilize your data effectively, you’ll be amazed at how it will revolutionize the management and negotiation of your payer rates. Successfully negotiated payer contracts are an essential part of a sound financial strategy.
Leveling the Playing Field
Unfortunately, when physician practices negotiate contracts with payers it is rarely a level playing field. Insurance companies have vast amounts of data and sophisticated modeling tools to give them a tremendous advantage in negotiating rates. Conversely, health care providers often lack sufficient analytical tools and experience when it comes to contract knowledge. These insufficiencies can end up costing the practice millions of dollars.
In order to level the playing field, providers must utilize their billing and contract data to analyze proposed rates and their effect on a practice’s top line. In this webinar, we will step you through the process of improving your practice revenue through data-powered payer contract negotiation. You will learn how to use your own data to analyze proposed rates, better negotiate and understand the effect on the practice.
Watch this to webinar to learn how to up your payer rates game by:
- Aggregating your clinical and financial utilization data
- Analyzing costs and quality measures
- Identifying inefficiencies & opportunities
Understanding how to navigate the new CMS value-based reimbursement reporting guidelines and regulations can be tricky, but certainly not impossible.
In this second session of our educational webinar series addressing value-based reimbursement, we explore group reporting options (GPRO), review the Consumer Assessment of Healthcare Providers and Systems (CAHPS) and examine its requirements, patient eligibility, & survey implementation.
So what exactly is GPRO and CAHPS?
Group practices with two or more eligible clinicians (ECs) can register with CMS to report PQRS data through the group practice reporting option (GPRO). These group practices must have grouped their National Provider Identifiers (NPI) under a single Taxpayer Identification Number (TIN) umbrella to be eligible. So, if your practice, hospital, and/or health network represents two or more eligible clinicians that bill under the same TIN then you’re eligible for group reporting.
CAHPS includes consumer and patient surveys that ask them to report on and evaluate their healthcare experiences. CAHPS surveys are not customer service surveys. Instead, the survey’s cover topics that are important to consumers, focusing on those aspects of quality consumers are best qualified to evaluate.
If your group practice registers for PQRS by the June 30th deadline and consists of between 2 and 99 ECs, then you may elect to include CAHPS for PQRS as part of your PQRS submission. If your group practice consists of 100 or more eligible clinicians (ECs) then it is actually required.
To learn more, watch the video below.
In April 2015, Congress addressed and ended the highly unpopular SGR Fee-For-Service Medicare reimbursement model in favor of the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA).
MACRA moves healthcare away from a fee-for-service mindset towards a value-based care mindset where high-quality care at a reduced cost is rewarded.
Over the course of this year, we will be hosting a series of webinars to help you understand how to navigate MACRA and how to prepare for the changes.
In this webinar session, Moshe Starkman, Equation Senior Consultant and Product Specialist, discusses:
- The creation of the Merit-Based Incentive Payment System (MIPs) including the four components of the MIPS composite performance score.
- The differences between PQRS and Quality component of the MIPS CPS.
- The proposed Medicare reimbursement bonus and penalty schedule.
Fill out the form below to watch the webinar.
Figuring out the true value of your employed physicians can be nearly impossible unless you have access to a health system’s data — analyzing the data of a physician or clinic is not enough. You need the gamut of data to understand the value a physician or clinic has for a patient population.
Now, more than ever, we have endless data available to us — the key is aggregating, mapping, and then employing it so that it gives you insights to improve the value of care. Downstream analysis is one of the best way to do this.
Downstream Analysis can break down:
- Physician referral patterns
- Patient consumption patterns
- Total cost of an episode of care
- Population management opportunities
The above insights are key to helping leaders of a health system to truly serve its patient populations. We have recorded the following webinar to help you learn more how Downstream Analyzer can arm your healthcare system’s leaders with the right data at the right time.
Visit coding is a critical component to the sustained strength of a physician’s practice. But how do you know whether or not the services provided are being coded correctly?
In this webinar session, you will learn how to utilize visit coding data to validate services rendered, maximize revenue, and avoid potential compliance issues.
Quantifying physician productivity can be a challenge, but it’s an important step toward improving your healthcare system as a whole. Unfortunately, the vast majority of metrics used to gauge health care productivity do not look at the right output.
In this webinar, attendees will learn how to uncover the key productivity factors that will vastly improve physician productivity.
The new year is around the corner and for many hospitals, that means it’s time to conduct the Community Health Needs Assessment. We’ve got the scoop on what you need to know to ensure your CHNA meets all of the IRS standards and how to bring down your cost by as much as half.
In this webinar, we walk through the CHNA process and insights gained by one of our clients. Participants will gain an understanding of the CHNA process, the types of data they need to collect and how to go from planning to implementation.
To download the CHNA Checklist, click here: Equation CHNA Checklist
Kyle Kobe, Equation Founder and Principal
Nicole Hayes, Product Manager at CentraForce
Howard Salmon, Equation Principal
In this webinar, Equation Principal Kyle Kobe will explain and illustrate how to quantify value through patient entry-point time sequencing, quantification, and analysis. Through this process, health systems can pinpoint opportunities for improvement in patient access and care while benefiting the community as a whole.
Kyle Kobe is a Principal and founding partner at Equation. He is an expert in the physician economic enterprise. He is an industry leader in defining economic relationships and building physician-hospital alignment financial models as well as an innovator in population health management tools.