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ACP Proposes Improvement To MACRA
The American College of Physicians (ACP) has offered what it considers to be improvement recommendations to the proposed rule to implement the Medicare Access and CHIP Reauthorization Act (MACRA). The recommendations, submitted via letter June 27 to the Centers for Medicare & Medicaid Services’ (CMS) acting administrator Andy Slavitt, would replace what the ACP calls an unnecessarily complex quality scoring system with a “much simpler and understandable approach,” revamp how use of health information technology is reported “to make it less burdensome and more relevant to clinicians,” offer safe harbors for smaller practices until a “virtual reporting system is established,” and provide expanded choices and opportunities for physician-led models to qualify for higher payments as “alternative advanced payment models.”
The recommendations are aligned with three principles: 1) The new payment systems should reflect the lessons from current and past programs and effectively allow for ongoing innovation and learning; 2) CMS should work to ensure patients, families, and their relationships with their physicians are at the forefront of thinking in developing the new payment systems; and 3) CMS should collaborate with specialty societies, frontline clinicians, and electronic health record vendors in the development, testing, and implementation of measures with a focus on decreasing clinician burden and integrating the measurement of and reporting on performance with quality improvement and care delivery.
“It is critically important to recognize that the legislative intent of MACRA is to truly improve care for Medicare beneficiaries, and thus the policy that is developed to guide these new value-based payment programs must be thoughtfully considered in that context,” said Robert McLean, MD, FACP, chair of ACP’s medical practice and quality committee. For more information, visit www. acponline.org/acp-newsroom.
IT Software Providers Partner on Outpatient Revenue Cycle Service
A partnership between an analytics company and an organization that specializes in revenue cycle management for outpatient facilities is expected to create an integrated billing solutions program for healthcare providers. According to officials with Change Healthcare, Nashville, TN, a provider of software and analytics, network solutions, and technology-enabled services designed to enable “smarter” care, and SourceMed, Birmingham, AL, a manufacturer of outpatient software solutions and revenue cycle-management services, the two groups are collaborating to bring solutions that will: 1) help program managers improve billing processes and enhance referral relationships; and 2) assist in the operation of more efficiently while eliminating many manual processes and automating revenue cycle workflows.
“Outpatient providers such as rehabilitation therapy and ambulatory surgery centers are facing increasing pressures to process billing and collections from multiple diverse entities,” said Kareem Saad, executive vice president of strategy and business development for SourceMed. “These organizations need solutions that reduce manual intervention for administrative staff and increase transparency for the patient. This strategic partnership with Change Healthcare will improve patient and provider relationships and keep the focus on successful outcomes versus financial reconciliation.”
Report: Docs Received $7.5 billion From Big Pharma in 2015
A new report from the Centers for Medicare & Medicaid Services (CMS) claims healthcare companies in the United States gave physicians and teaching hospitals $7.5 billion last year to fund research as well as to pay for such things as meals. According to 2015 payment data from the Open Payments program, which requires manufacturers to divulge payments to doctors and teaching hospitals, funds were divided into such major areas as $2.6 billion in general payments (not related to research), $3.89 billion to research, and $1.03 billion in ownership or stock interests held by physicians or their immediate families. CMS also found the amount and distribution of payments and stock interests remained consistent between 2014 and 2015. Additionally, CMS officials have determined that in 2015 about 2.26% of all payments between physicians and drug companies were related to opioid drugs. They believe the Open Payments program, which collects information about various financial relationships, has helped shed light on the relationships doctors have with other entities.
For more information, visit www.cms.gov/openpayments.
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