practice management
Local Firm Supporting CMS and NY State Programs to Transform Care in Western NY September 30th Deadline Approaches for FREE Practice Transformation Assistance Value-based payment (VBP) is here. Well, almost. VBP arrangements are emerging rapidly to take the place of feefor-service reimbursement, refocusing physicians’ and other providers’ attention to a new era of rewarding quality and outcomes over volume of services performed. Medicare and Medicaid reforms and demonstrations of VBP are accelerating, influencing an increasing cohort of the reimbursement policies of public and private payers here in New York State. To prepare, physicians in western New York should research and evaluate changes required to transform their practices to reconfigure how they offer care and manage their patients’ health and medical needs. In other words, practice transformation should be on every physician’s front burner. Luckily, CMS, NYS DOH, and the New York eHealth Collaborative (NYeC), have programs in place offering services to help providers prepare for and successfully embrace these changes. If you regularly hear about “MACRA,” “MIPS” and “QPP,” or if you are asked to participate in an ACO then you know
that the world of paying for care is changing, ‘big time.’ And, with that change, comes one of the most substantive overhauls of the way in which physicians and other health practitioners deliver care to their patients since the introduction of Medicare and Medicaid in the mid-60s. Congress passed the Medicare Access & CHIP Reauthorization Act of 2015, aka MACRA, which got the ball rolling with due speed toward VBP, in which Medicare payments were based on quality measurements rather than volume.
As the American College of Physicians has noted: “The MACRA law eliminated the sustainable growth rate (SGR) formula that had previously been used to calculate Medicare payments to physicians and had resulted in repeated threats of severe payment cuts. The law provides a more predictable Medicare payment schedule for physicians and other clinicians, while moving the payment system away from a volume-based system toward a system that rewards value. This new payment system is called the Quality Payment Program (QPP).” MACRA launched the Merit-based Incentive Payment Sys-
Source: “Value-based Reimbursement vs. Volume-based Care, by McKesson Corporation 2016
20 I VOLUME 3 I 2017 WNYPHYSICIAN.