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On Valuing Physician Work in Medicare

3 Responses

1. Ann Miller RN MHA, on June 2, 2015 at 10:40 PM said:

   CMS Opens its Data to the Private Sector

   The Centers for Medicare and Medicaid Services will make its data available to the private sector for the first time, the agency’s acting administrator announced Tuesday in Washington. Previously, CMS data has only been available to researchers not intending to develop commercial products. It now will be available to innovators and entrepreneurs, CMS Acting Administrator Andy Slavitt said at the Health Datapalooza conference. “We do this with the clear expectation that you will create new streams of tools to improve care.”

   CMS will further allow companies to combine the agency’s data with private data. “In taking this step, we challenge others with proprietary data to follow our lead and remove barriers to getting better care faster,” Slavitt said. “It will be good for everybody.” In a statement, CMS noted that the data would not permit identification of patients, but would provide the identity of providers of care. The agency in September 2015 will start accepting research requests.

   Source: Brian M. Kalish, Health Data Management [6/2/15]

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2. Ann Miller RN MHA, on November 4, 2015 at 10:24 PM said:

   Physicians Decry Broken Promise of Medicare Raise in 2016

   The law that repealed Medicare’s sustainable growth rate (SGR) formula for physician pay called for an annual raise of 0.5% from 2016 through 2019 as part of a transition to value-based reimbursement. When Congress passed the law in April, some leaders of organized medicine noted that the modest raise lagged behind the inflation rate, but said it was better than nothing. It was certainly better than the disastrous 21% pay cut that the SGR formula would have triggered in 2016.

   Medical societies sold their membership on the legislation, called the Medicare Access and CHIP Reauthorization Act (MACRA), in part by saying it would stabilize Medicare rates for several years.

   However, the promised raise of 0.5% turned into a 0.3% pay cut in the fine print of the final 2016 Medicare fee schedule released last week. The reason? The Affordable Care Act (ACA) and several other laws that set Medicare reimbursement policy trumped MACRA.

   Source: Robert Lowes, Medscape News [11/3/15]

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3. Claire, on May 3, 2016 at 10:13 AM said:

   New Medicare Penalty Hits Small Groups, Solo Physicians Hardest

   Medicare’s new compensation formula will bestow performance bonuses as high as 4% on an estimated 412,000 physicians and other clinicians in 2019 and impose corresponding penalties on another 346,000, mostly in practices of from one to 24 members, according to proposed regulations recently released by the Centers for Medicare & Medicaid Services (CMS).

   One physician organization is expressing dismay about a payment system that seems to work against smaller practices. “It’s extremely concerning,” said Anders Gilberg, senior vice president of government affairs for the Medical Group Management Association (MGMA), in an interview with Medscape Medical News. “Any program like this should give physicians the opportunity to succeed regardless of practice size. “Why wouldn’t you structure it so it will lift all boats?”

   Source: Robert Lowes, Medscape [4/28/16]

   Claire

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