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You’ve probably seen first-hand or have heard from your colleagues how patients who don't receive adequate levels of after care services can often wind up relapsing and/or need to be readmitted.
What enables doctors and nurses to “see” patients without the patient needing to come into the office or the medical professional having to make a house call? The answer is telemedicine.
There are many aspects of MACRA, and it's important you're familiar with all of them.
You’ve been working in the healthcare profession for some time now. While you have a good understanding of the fundamentals of your work, whether in a general practice or specialty, you are only beginning to become acquainted with the topic of population health. As the nation continues to work out the details of making health care services more widely available to all, issues of population health become all the more important.
In modern healthcare, more attention is being paid lately to the level of quality we provide to our patients, rather than emphasizing how much (the quantity) care is being doled out to them. To that end, the U.S. government has lately been promoting Alternative Payment Models or APMs in support of the goals of the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA).
When you first entered the medical profession, patients typically were asked to make reimbursements for treatment under a fee-for-service system. That is a natural aspect of providing healthcare in a capitalist country like the United States, where the focus can sometimes be on profits rather than on achieving the highest standards of care.
Does your medical organization currently provide care for Medicare or Medicaid patients, or are you planning to begin offering service to them in the near future? You should know that the government has a keen interest in streamlining how we deliver healthcare in the United States, with an emphasis on quality over quantity. To that end, the Centers for Medicare and Medicaid Services (also known as CMS) launched its Medicare and Medicare Electronic Health Record Incentive Programs in 2011 to encourage eligible providers to demonstrate Meaningful Use.
In any business, it will typically take a lot more time, effort and other resources to attract new customers than it does to retain them. The same typically holds true in healthcare organizations. Better patient engagement fosters trust between patients and the professionals treating them and is key for maintaining continuity of care. There are also financial considerations to keep in mind, of course, that will motivate practices to do their best to engage with each patient to keep them happy and satisfied with the services they receive.
When tax dollars are fed into the healthcare system, taxpayers will naturally have a vested interest in seeing costs lowered and efficiency improved. From family doctors to specialists of all types, there is a move toward promoting quality of care over quantity of care.
Making value-based (VB) healthcare work doesn’t have to be challenging if the practice, group, or network has two things: (1) the proper automation tools, and (2) the resources on which to rely in transforming them from fee-for-service into VB. First, a little VB background. The Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) is a law designed to encourage more medical providers, otherwise known as “Eligible Clinicians” or “ECs” in MACRA-speak, to embrace VB medicine. For 2017, CMS has designated MDs, DOs, DDSs, DMDs, NPs, PAs, CNAs, and CRNAs as ECs. If you’re one of these, and you’re not exempt, you can and should move into the VB medicine world of quality vs. quantity.
The following excerpt is from an article written by Vera Gruessner. It originally appeared on HealthPayer Intelligence. Regardless of which political party is in Congress, the healthcare industry is steadily moving forward with value-based care reimbursement.