keyword
MENU ▼
Read by QxMD icon Read
search

physician payment incentive

keyword
https://www.readbyqxmd.com/read/28766194/macra-and-the-changing-medicare-payment-landscape
#1
Steven L Chen, Matthew R Coffron
BACKGROUND: The Medicare Access and CHIP Reauthorization Act (MACRA) is being implemented in 2017 by the Centers for Medicare and Medicaid Services (CMS) as the Quality Payment Program (QPP) and will have important and far reaching effects on how physicians are reimbursed and on how they practice. The QPP modifies the Medicare physician payment system by eliminating the Sustainable Growth Rate formula and incorporating the existing Physician Quality Reporting System, EHR Incentive Program, and the Value Modifier into a single new Merit-based Incentive Payment System (MIPS)...
August 1, 2017: Annals of Surgical Oncology
https://www.readbyqxmd.com/read/28748535/financial-incentives-and-physician-practice-participation-in-medicare-s-value-based-reforms
#2
Adam M Markovitz, Patricia P Ramsay, Stephen M Shortell, Andrew M Ryan
OBJECTIVES: To evaluate whether greater experience and success with performance incentives among physician practices are related to increased participation in Medicare's voluntary value-based payment reforms. DATA SOURCES/STUDY SETTING: Publicly available data from Medicare's Physician Compare (n = 1,278; January 2012 to November 2013) and nationally representative physician practice data from the National Survey of Physician Organizations 3 (NSPO3; n = 907,538; 2013)...
July 26, 2017: Health Services Research
https://www.readbyqxmd.com/read/28717900/elements-of-program-design-in-medicare-s-value-based-and-alternative-payment-models-a-narrative-review
#3
Karen E Joynt Maddox, Aditi P Sen, Lok Wong Samson, Rachael B Zuckerman, Nancy DeLew, Arnold M Epstein
Increasing emphasis on value in health care has spurred the development of value-based and alternative payment models. Inherent in these models are choices around program scope (broad vs. narrow); selecting absolute or relative performance targets; rewarding improvement, achievement, or both; and offering penalties, rewards, or both. We examined and classified current Medicare payment models-the Hospital Readmissions Reduction Program (HRRP), Hospital Value-Based Purchasing Program (HVBP), Hospital-Acquired Conditions Reduction Program (HACRP), Medicare Advantage Quality Star Rating program, Physician Value-Based Payment Modifier (VM) and its successor, the Merit-Based Incentive Payment System (MIPS), and the Medicare Shared Savings Program (MSSP) on these elements of program design and reviewed the literature to place findings in context...
July 17, 2017: Journal of General Internal Medicine
https://www.readbyqxmd.com/read/28664439/sages-quality-initiative-an-introduction
#4
Anne Lidor, Dana Telem, Curtis Bower, Prashant Sinha, Rocco Orlando, John Romanelli
The Medicare program has transitioned to paying healthcare providers based on the quality of care delivered, not on the quantity. In May 2015, SAGES held its first ever Quality Summit. The goal of this meeting was to provide us with the information necessary to put together a strategic plan for our Society over the next 3-5 years, and to participate actively on a national level to help develop valid measures of quality of surgery. The transition to value-based medicine requires that providers are now measured and reimbursed based on the quality of services they provide rather than the quantity of patients in their care...
August 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28654621/measuring-provider-performance-for-physicians-participating-in-the-merit-based-incentive-payment-system
#5
Lee Squitieri, Kevin C Chung
In 2017, the Centers for Medicare and Medicaid Services began requiring all eligible providers to participate in the Quality Payment Program or face financial reimbursement penalty. The Quality Payment Program outlines two paths for provider participation: the Merit-Based Incentive Payment System and Advanced Alternative Payment Models. For the first performance period beginning in January of 2017, the Centers for Medicare and Medicaid Services estimates that approximately 83 to 90 percent of eligible providers will not qualify for participation in an Advanced Alternative Payment Model and therefore must participate in the Merit-Based Incentive Payment System program...
July 2017: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/28605555/operationalizing-multidisciplinary-assessment-and-treatment-as-a-quality-metric-for-interventional-pain-practices
#6
Edward K Heres, David Itskevich, Ajay D Wasan
Objective.:  Quality improvement (QI) is an underutilized approach among pain medicine specialists to improve comprehensive pain assessment and the delivery of multimodal pain care. We report the results of a QI program that utilized peer review and financial incentives to improve these processes in interventional pain clinics. Design.:  Retrospective chart review. Setting.:  Eight academic and community-based practices that included separate hospital-based and non-hospital-based interventional pain clinics...
June 12, 2017: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/28566988/the-impact-of-order-source-misattribution-on-computerized-provider-order-entry-cpoe-performance-metrics
#7
George A Gellert, Linda Catzoela, Lajja Patel, Kylynn Bruner, Felix Friedman, Ricardo Ramirez, Lilliana Saucedo, S Luke Webster, John A Gillean
BACKGROUND: One strategy to foster adoption of computerized provider order entry (CPOE) by physicians is the monthly distribution of a list identifying the number and use rate percentage of orders entered electronically versus on paper by each physician in the facility. Physicians care about CPOE use rate reports because they support the patient safety and quality improvement objectives of CPOE implementation. Certain physician groups are also motivated because they participate in contracted financial and performance arrangements that include incentive payments or financial penalties for meeting (or failing to meet) a specified CPOE use rate target...
2017: Perspectives in Health Information Management
https://www.readbyqxmd.com/read/28554209/real-world-evidence-and-the-behavioral-economics-of-physician-prescribing
#8
Bruce Feinberg
The projections for the rising cost of healthcare have spurred robust dialogue, and among the many targets for cost control are specialty drugs. An important question thus becomes: Are behavioral economic factors driving physician prescribing? This article presents a review of leading behavioral economic theories and their application to the results of an Oncology Medical Home pilot that reversed incentives from drug administration to patient care. A host of these theories may explain the irrational economic actors in regard to physician prescribing, including heuristics, framing, and defaults...
April 2017: American Journal of Managed Care
https://www.readbyqxmd.com/read/28545159/the-value-transformation-of-health-care-impact-on-neuromuscular-and-electrodiagnostic-medicine
#9
Pushpa Narayanaswami, Millie Suk, Lyell K Jones
Beginning in 2017, most physicians who participate in Medicare are subject to the Medicare Access and CHIP Reauthorization Act (MACRA), the milestone legislation that signals the US health care system's transition from volume-based to value-based care. Here we review emerging trends in development of value-based healthcare systems in the US. MACRA and the resulting Quality Payment Program create 2 participation pathways, the Merit-based Incentive Payment System (MIPS) and the Advanced Alternative Payment Model (AAPM) pathway...
May 25, 2017: Muscle & Nerve
https://www.readbyqxmd.com/read/28531288/an-evaluation-of-systemic-reforms-of-public-hospitals-the-sanming-model-in-china
#10
Hongqiao Fu, Ling Li, Mingqiang Li, Chunyu Yang, William Hsiao
Low- and middle-income countries (LMICs) have been searching for effective strategies to reform their inefficient and wasteful public hospitals. Recently, China developed a model of systemic reforms called the Sanming model to address the inefficiency and waste at public hospitals. In this article, we explain and evaluate how the Sanming model reformed its 22 public hospitals in 2013 by simultaneously restructuring the hospital governance structure, altering the payment system to hospitals, and realigning physicians' incentives...
May 20, 2017: Health Policy and Planning
https://www.readbyqxmd.com/read/28419657/a-new-approach-to-clinical-research-integrating-clinical-care-quality-reporting-and-research-using-a-wound-care-network-based-learning-healthcare-system
#11
Thomas E Serena, Caroline E Fife, Kristen A Eckert, Raphael A Yaakov, Marissa J Carter
The disparity between ideal evidence from randomized controlled trials and real-world evidence in medical research has prompted the United States Food and Drug Administration to consider the use of real-world data to better understand safety and effectiveness of new devices for a broader patient population and to prioritize real-world data in regulatory decision making. As the healthcare system transitions from volume- to value-based care, there is a growing need to harness the power of real-world data to change the paradigm for wound care clinical research and enable more generalizable clinical trials...
April 17, 2017: Wound Repair and Regeneration
https://www.readbyqxmd.com/read/28414044/the-impact-of-the-medicare-access-and-chip-reauthorization-act-on-the-field-of-ophthalmology
#12
Brenton Kinker, Kaitlyn Dobesh, Nariman Nassiri, Mark S Juzych, M Roy Wilson
PURPOSE: To analyze the impact of the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) on the field of ophthalmology. DESIGN: A perspective on the effects of MACRA's Quality Payment Program after analysis of the proposed rule, final rule, and commentary submitted by relevant stakeholders. RESULTS: Physicians will need to use 1 of 2 payment structures: Merit-Based Incentive Payment Systems (MIPS) or Alternative Payment Models (APMs)...
July 2017: American Journal of Ophthalmology
https://www.readbyqxmd.com/read/28392029/improving-care-and-education-through-a-radiology-resident-driven-clinical-consultation-service
#13
Gayle R Salama, Courtney Sullivan, Daniel Holzwanger, Ashley E Giambrone, Robert J Min, Keith D Hentel
RATIONALE AND OBJECTIVE: As health care moves toward bundled payment systems and merit-based incentive models, increasing awareness of the value of the radiologist is essential. A resident-driven clinical imaging rounds (CIR) program initiated at our institution allows radiologists to actively and directly participate in the team-based medical model. A retrospective review of survey data evaluated the qualitative and quantitative effects of CIR on clinical management, communication, and education of referring providers and radiology residents...
April 6, 2017: Academic Radiology
https://www.readbyqxmd.com/read/28389134/private-bundles-the-nuances-of-contracting-and-managing-total-joint-arthroplasty-episodes
#14
Ameer M Elbuluk, Owen R O'Neill
In recent years, bundled payment reimbursement models have been used to address the unsustainable rising cost of healthcare. Centers for Medicare and Medicaid Services initiatives, such as Bundled Payment for Care Improvement Program, have already demonstrated their ability to create financial and performance accountability in the public sector. More recently, these value-based models have been introduced among private payers to increase coordination, quality, and efficiency. Bundled payment strategies provide incentives for physicians and healthcare professionals to eliminate unnecessary services and reduce costs...
February 16, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28376520/will-the-fixes-fall-flat-prospects-for-quality-measures-and-payment-incentives-to-control-healthcare-spending
#15
Erik Hauswald, David Sklar
Payment systems in the US healthcare system have rewarded physicians for services and attempted to control healthcare spending, with rewards and penalties based upon projected goals for future spending. The incorporation of quality goals and alternatives to fee-for-service was introduced to replace the previous system of rewards and penalties. We describe the history of the US healthcare payment system, focusing on Medicare and the efforts to control spending through the Sustainable Growth Rate. We describe the latest evolution of the payment system, which emphasizes quality measurement and alternative payment models...
April 2017: Southern Medical Journal
https://www.readbyqxmd.com/read/28376461/increased-health-information-technology-adoption-and-use-among-small-primary-care-physician-practices-over-time-a-national-cohort-study
#16
Diane R Rittenhouse, Patricia P Ramsay, Lawrence P Casalino, Sean McClellan, Zosha K Kandel, Stephen M Shortell
PURPOSE: Implementation and meaningful use of health information technology (HIT) has been shown to facilitate delivery system transformation, yet implementation is far from universal. This study examined correlates of greater HIT implementation over time among a national cohort of small primary care practices in the United States. METHODS: We used data from a 40-minute telephone panel survey of 566 small primary care practices having 8 or fewer physicians to investigate adoption and use of HIT in 2007-2010 and 2012-2013...
January 2017: Annals of Family Medicine
https://www.readbyqxmd.com/read/28375501/seven-ethical-issues-affecting-neurosurgeons-in-the-context-of-health-care-reform
#17
T Forcht Dagi
Ethical discussions around health care reform typically focus on problems of social justice and health care equity. This review, in contrast, focuses on ethical issues of particular importance to neurosurgeons, especially with respect to potential changes in the physician-patient relationship that may occur in the context of health care reform.The Patient Protection and Affordable Care Act (ACA) of 2010 (H.R. 3590) was not the first attempt at health care reform in the United States but it is the one currently in force...
April 1, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28373336/the-medicare-access-and-chip-reauthorization-act-effects-on-medicare-payment-policy-and-spending
#18
Peter S Hussey, Jodi L Liu, Chapin White
In 2015, Congress repealed the Sustainable Growth Rate formula for Medicare physician payment, eliminating mandatory payment cuts when spending exceeded what was budgeted. In its place, Congress enacted the Medicare Access and CHIP Reauthorization Act (MACRA), which established a two-track performance-based payment system that encourages physicians to participate in alternative payment models. MACRA could have huge effects on health care delivery, but the nature of those effects is highly uncertain. Using the RAND Corporation's Health Care Payment and Delivery Simulation Model, we estimated the effects of MACRA on Medicare spending and utilization and examined how effects would differ under various scenarios...
April 1, 2017: Health Affairs
https://www.readbyqxmd.com/read/28373329/substantial-physician-turnover-and-beneficiary-churn-in-a-large-medicare-pioneer-aco
#19
John Hsu, Christine Vogeli, Mary Price, Richard Brand, Michael E Chernew, Namita Mohta, Sreekanth K Chaguturu, Eric Weil, Timothy G Ferris
Alternative payment models, such as accountable care organizations (ACOs), attempt to stimulate improvements in care delivery by better alignment of payer and provider incentives. However, limited attention has been paid to the physicians who actually deliver the care. In a large Medicare Pioneer ACO, we found that the number of beneficiaries per physician was low (median of seventy beneficiaries per physician, or less than 5 percent of a typical panel). We also found substantial physician turnover: More than half of physicians either joined (41 percent) or left (18 percent) the ACO during the 2012-14 contract period studied...
April 1, 2017: Health Affairs
https://www.readbyqxmd.com/read/28365038/future-considerations-for-clinical-dermatology-in-the-setting-of-21st-century-american-policy-reform-the-medicare-access-and-children-s-health-insurance-program-reauthorization-act-and-the-merit-based-incentive-payment-system
#20
John S Barbieri, Jeffrey J Miller, Harrison P Nguyen, Howard P Forman, Jean L Bolognia, Marta J VanBeek
As the implementation of the Medicare Access and Children's Health Insurance Program Reauthorization Act begins, many dermatologists who provide Medicare Part B services will be subject to the reporting requirements of the Merit-based Incentive Payment System (MIPS). Clinicians subject to MIPS will receive a composite score based on performance across 4 categories: quality, advancing care information, improvement activities, and cost. Depending on their overall MIPS score, clinicians will be eligible for a positive or negative payment adjustment...
June 2017: Journal of the American Academy of Dermatology
keyword
keyword
90583
1
2
Fetch more papers »
Fetching more papers... Fetching...
Read by QxMD. Sign in or create an account to discover new knowledge that matter to you.
Remove bar
Read by QxMD icon Read
×

Search Tips

Use Boolean operators: AND/OR

diabetic AND foot
diabetes OR diabetic

Exclude a word using the 'minus' sign

Virchow -triad

Use Parentheses

water AND (cup OR glass)

Add an asterisk (*) at end of a word to include word stems

Neuro* will search for Neurology, Neuroscientist, Neurological, and so on

Use quotes to search for an exact phrase

"primary prevention of cancer"
(heart or cardiac or cardio*) AND arrest -"American Heart Association"