Multiple Chronic Conditions Blog

2017 The Year Of Transition

Donald Trump’s election as President and Republicans controlling the Senate and the House predict that some type of congressional action with the Affordable Care Act (ACA) will occur. Unlike the ACA, the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) will NOT undergo significant legislative changes – since this bipartisan legislation passed in the Senate in April with a vote of 92 to 8.

Transitioning to Quality Payment, January 1, 2017

The Quality Payment Program’s first performance period under MACRA (Medicare Access and CHIP Reauthorization Act), legislation will open on January 1, 2017 and will close December 31, 2017. The Centers for Medicare and Medicaid Services predict 88% of Medicare providers will fall under the Merit-Based Incentive Payment System or MIPS beginning as early as January 1, 2017 or as late as October 2, 2017.

US Department of Health and Human Services, October 14, 2016 Finalization of the Quality Payment Program

On October 14, 2016, the US Department of Health and Human Services (HHS) issued the final rule with comment period implementing the Quality Payment Program - a direct result of the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA). MACRA legislation ended the Sustainable Growth Rate formula, which threatened providers who participate in Medicare reimbursement with potential payment cliffs for 13 years.

Alternatives to Opioids for Somatic Pain

The Centers for Disease Control and Prevention (CDC), early this year released the national guidelines for Prescribing Opioids for Chronic Pain. The primary objective for this guideline is to direct provider and patient communication about the benefits and risks of opioid therapy, improve the safety and effectiveness of pain treatment and reduce the overall risks associated with long-term opioid use.

The Federal Register on July 15th released the Medicare Program

The Federal Register on July 15th released the Medicare Program; Revisions to Payment Policies under the Physician Fee Schedule and Other Revisions to Part B for CY 2017; Medicare Advantage Pricing Data Release; Medicare Advantage and Part D Medical Low Ratio Data Release; Medicare Advantage Provider Network Requirements; Expansion of Medicare Diabetes Prevention Program Model.

Health Care Planning and Learning Action Network Roadmaps to Population Based Payment and Clinical Episode Payment

Since January, 2015 the President’s development of the Health Care Planning and Learning Action Network has produced over 9 White Papers on directing the US health care system on Population Based Payment (PBP) and Clinical Episode Payment (CEP). These White Papers were open to the public for review and comments prior finalization.

Register for Free AHRQ Webinar on Shared Decision Making for Chronic Conditions and Long Term Care Planning

A webinar from The Agency for Healthcare Research and Quality (AHRQ) July 26 will examine how shared decision making can be used to manage chronic conditions and facilitate the long term care planning needs of aging Veterans and adults with chronic conditions.

Six Months to Prepare for MACRA Legislation

The National Quality Strategy (NQS), led by the Agency for Health, Research and Quality (AHRQ), under the direction of the US Department of Health and Human Services hosted a Webinar on May 17th, highlighting the 2015 National Healthcare Quality and Disparities Report and 5th Anniversary Update on the National Quality Strategy.

Accelerating and Aligning Population Based Payment Models Patient Attributes - Final White Paper

The Health Care Payment Learning and Action Network (HCPLAN) on May 13, 2016 released the White Paper of 10 recommendations to guide the patient attribution process as the US health care system moves toward Population Based Medicine (PBM). HCPLAN identifies 3 guiding principles to support these recommendations

Centers for Medicare and Medicaid Open Comments on MACRA

I continue to read and review multiple comments made by providers who are pushing back on the upcoming MACRA changes - unfortunately, all of this is bigger and moving faster than any health care tsunami in US history. We have too!