MACRA and the Move to Value-Based Healthcare
Skip to main content
Sister Publication Links
  • Modern Healthcare Metrics
MDHC_Logotype_white
Subscribe
  • Subscribe
  • Register
  • Login
  • News
    • This Week's News
    • Providers
    • Insurance
    • Government
    • Finance
    • Technology
    • Safety & Quality
    • People
    • Regional News
    • Digital Edition
    • Tenet selling two Memphis area hospitals to Methodist Le Bonheur
      California's landmark privacy law will have 'subtle' effect on hospitals
      MACPAC thinks HHS needs new measures for Medicaid payment errors
      CMS to repay hospitals for doctor's visits
    • Tenet selling two Memphis area hospitals to Methodist Le Bonheur
      HealthPartners sheds more than 400 jobs across three rounds of cuts
      Kaiser Permanente seeks to address trauma in 25,000 schools by 2023
      KPC Group misses key deadline on Verity hospitals purchase
    • Michigan Blues makes deals with seven health organizations aiming to bend cost curve
      ACA exchange enrollment lags as deadline nears
      Plan members unlikely to benefit from Supreme Court risk corridor battle
      Joan Budden
      Q&A: Priority Health CEO eager to share best practices with Total Health Care
    • CMS to repay hospitals for doctor's visits
      Capitol Building with pills
      Week Ahead: House to vote on drug bill; SCOTUS hears risk-corridor case
      MedPAC thinks hospice payments are too high
      MedPAC says ambulatory surgical centers don't need a pay raise
    • Analysts to CommonSpirit Health: Show us the savings
      Smallest hospitals saw biggest earnings gains last month
      Sutter Health postpones financial filing
      doctor helping patient stock image Sandoz
      Sponsored Content Provided By Sandoz
      As hospital executives look to reduce costs, biosimilars offer a compelling option
    • astronaut
      Astronauts developed bloodstream issues in space
      Sponsored Content Provided By ABM Healthcare
      Protecting and Maintaining Medical Devices
      human hand robotic hand stock image
      Sponsored Content Provided By Deloitte
      The Health System of the Future: How Digital Health Technology is Transforming Care
      EHR
      EHR vendors most in-use throughout Medicare incentive program
    • Hospitals need more than HCAHPS to measure patient experience, report says
      Promising greater safety, a tiny widget creates chaos for tube feeders
      IHI releases principles for improving patient safety measures
      MRIs of dense breasts find more cancer but also false alarms
    • Community Health Systems' CFO to retire at end of year
      Kaiser Permanente names Gregory Adams CEO
      Google Health hires AliveCor's chief medical officer
      Trinity Health appoints new COO: Ben Carter
    • Midwest
    • Northeast
    • South
    • West
  • Special Features
    • Best Practices
    • InDepth Special Reports
    • Innovations
    • Chest x-ray from a patient with a vaping-related lung injury
      Vaping-related cases lead to care guidelines from Intermountain
      Arkansas Children’s was a founding partner in Solutions for Patient Safety.
      Children's hospitals collaborate rather than compete on patient safety
      Peer recovery specialists at St. Barnabas Medical Center work with nurse Brenna Zarra.
      Peer recovery helping patients with addiction seek treatment
      UNC Health Care trains staff to treat dementia patients
    • Linda Kenney
      Patient advocate recalls two medical errors that nearly killed her
      Betsy Lehman
      Recent safety scandals suggest healthcare leaders haven't learned lessons
      Doctors and nurse with patient
      20 years after 'To Err is Human,' hospital care quality measures are still of little use
      Dr. Christine Cassel
      To err is human. That’s still true 20 years later, but some solutions to the problem aren’t helping
    • Advanced ICU Care
      Telemedicine helps rural hospitals meet intensivist shortage
      Randy Oostra, CEO of ProMedica
      HCR ManorCare deal laid foundation for ProMedica’s growth
      Paging Dr. Robot: Artificial intelligence moves into care
      A child being screened for vision problems using a smartphone.
      App screens kids for eye problems before they can talk
  • Transformation
    • Patients
    • Operations
    • Care Delivery
    • Payment
    • ProMedica doubles down on social needs data analysis
      Amazon taps first pharmacy for Alexa Rx management
      Trump administration unveils new price transparency rules
      A child being screened for vision problems using a smartphone.
      App screens kids for eye problems before they can talk
    • California's landmark privacy law will have 'subtle' effect on hospitals
      Health systems weigh return on investment as they ramp up tech
      VA dives into artificial intelligence R&D
      Home health to pare down therapy services, up telehealth offerings
    • Chest x-ray from a patient with a vaping-related lung injury
      Vaping-related cases lead to care guidelines from Intermountain
      Advanced ICU Care
      Telemedicine helps rural hospitals meet intensivist shortage
      Peer recovery specialists at St. Barnabas Medical Center work with nurse Brenna Zarra.
      Peer recovery helping patients with addiction seek treatment
      UNC Health Care trains staff to treat dementia patients
    • CMS to repay hospitals for doctor's visits
      Chart reviews boost Medicare Advantage payments by $6.7 billion, OIG finds
      Value-based pay still struggles to improve costs, quality
      Hospitals sue HHS over negotiated price disclosure rule
  • Data/Lists
    • Rankings/Lists
    • Data Points
    • Modern Healthcare Metrics
  • Op-Ed
    • Bold Moves
    • Breaking Bias
    • Commentaries
    • Letters
    • Vital Signs Blog
    • From the Editor
    • Randy Oostra, CEO of ProMedica
      HCR ManorCare deal laid foundation for ProMedica’s growth
      Steve Strongwater
      How Atrius Health stayed independent by not shying away from risk
      Why moving the VA to a new EHR was a pivotal decision
      Why AdventHealth's rebrand was more than a name change
    • Terry Shaw
      A diverse and inclusive culture should empower others
      Paving the path to diversity and inclusion
      The next step in healthcare evolution
      Breaking Bias: A road map to boost women and minorities into healthcare leadership
    • Dr. Richard Snyder
      Outdated privacy laws hinder coordinated care, especially in the fight against addiction
      David Dill and Keith Myers
      Healthcare partnerships are a proven path to better care, healthier communities
      Health systems need to devote more resources to caring for the caregivers
      Chip Kahn and Alan Morgan
      Rural healthcare needs innovation, policy changes to survive
    • Letters: Let’s keep humanity in discussions about patient safety
      Hospital with money
      Letters: Let providers set their prices,
 and then publish them all
      Letters: Ambulatory surgery centers aren't getting a break on regulation
      Letters: Rising Medicaid spending isn't a windfall for providers
    • Sponsored Content Provided By Optum
      How blockchain could ease frustration with the payment process
      Sponsored Content Provided By Optum
      Three steps to better data-sharing for payer and provider CIOs
      Sponsored Content Provided By Optum
      Reduce total cost of care: 6 reasons why providers and payers should tackle the challenge together
      Sponsored Content Provided By Optum
      Why CIOs went from back-office operators to mission-critical innovators
  • Awards
    • Nominate
    • Award Programs
    • Previous Award Programs
    • Other Award Programs
    • Nominations Open - Top 25 Minority Leaders
      Nominations Open - Health Care Hall of Fame
    • 100 Most Influential People
    • 50 Most Influential Clinical Executives
    • Best Places to Work in Healthcare
    • Health Care Hall of Fame
    • Healthcare Marketing Impact Awards
    • Top 25 Emerging Leaders
    • Top 25 Innovators
    • Top 25 Minority Leaders
    • Top 25 Women Leaders
    • Excellence in Nursing Awards
    • Design Awards
    • Top 25 COOs in Healthcare
    • 100 Top Hospitals
    • ACHE Awards
  • Events
    • Conferences
    • Galas
    • Webinars
    • Leadership Symposium
    • Healthcare Transformation Summit
    • Critical Connections: Social Determinants of Health Symposium
    • Women Leaders in Healthcare Conference
    • Workplace of the Future Conference
    • Strategic Marketing Conference
    • Health Care Hall of Fame Gala
    • Top 25 Women Leaders Gala
    • Best Places to Work Awards Gala
    • Top 25 Minority Leaders Gala (2020)
  • MORE +
    • Advertise
    • Media Kit
    • Newsletters
    • Jobs
    • People on the Move
    • Reprints & Licensing
MENU
Breadcrumb
  1. Home
  2. Government
Sponsored Content
This content was paid for by an advertiser and created in collaboration with Crain's Custom Content.
August 25, 2017 01:00 AM

MACRA and the Move to Value-Based Healthcare

  • Tweet
  • Share
  • Share
  • Email
  • More
    Print
    S. Lawrence Kocot, JD, LLM, MPA Principal and National Leader, KPMG Center for Healthcare Regulatory Insight

    The Medicare Quality Payment Program (QPP) encourages providers to deliver high-value care through performance-based payment adjustments under the Merit-Based Incentive Payment System (MIPS), or higher payment updates for participating in Advanced Alternative Payment Models (APMs). Modern Healthcare Custom Media asked KPMG's Larry Kocot about the state of preparedness for the QPP and opportunities to improve the transition to value-based care. Larry leads the KPMG Center for Healthcare Regulatory Insight and provides advice and counsel to companies on corporate strategy and regulatory matters relating to public health care programs, including Medicare and Medicaid.

    What do we know about how physicians are preparing for the Quality Payment Program?

    LK: This spring, KPMG and the American Medical Association (AMA) surveyed 1,000 physicians to establish a baseline understanding of physician awareness of and preparation for the QPP in the first performance year and the opportunities and challenges ahead. Although knowledge of the QPP and its requirements is increasing among physicians across practice sizes, practice settings, and specialties; the survey found that a majority of physicians still view reporting requirements as burdensome. Fewer than one in four feel well prepared to meet reporting requirements in 2017 and less than one in ten physicians feel very well prepared for long-term financial success. These findings suggest that the move to value-based reimbursement remains challenging for physicians, and more help is needed.

    Does the recent CMS proposed rule on the 2018 Performance Year ease the transition to value-based care?

    LK: Although our survey was released after publication of the CMS proposed rule, the proposed requirements for 2018 appear to reflect an appreciation for some of the early challenges revealed by our survey. The proposed rule should be seen as good news for those still transitioning to the QPP. For example, CMS proposes increasing the low-volume threshold for MIPS eligibility ($90,000 in billable Medicare services or 200 Medicare patients), providing additional flexibility (and bonuses) to physicians in practices of 15 or fewer, and allowing for continued use of 2014 Edition Certified Electronic Health Record Technology (CEHRT). These adjustments would give struggling practices a longer on-ramp to meet requirements and more fully invest in value-based care. Additionally, more guidance on virtual group participation and All-Payer APM qualification will allow physicians to refine and optimize their long-term QPP strategies. The proposed rule supports findings from our survey that the transition to the QPP is a journey requiring an iterative process between providers and payers.

    What are the barriers to more rapid adoption of APMs?

    LK: A core vision for the QPP is to increase the transition to Advanced APMs for providers of all sizes, specialties, practice settings, and value-based care experience. However, many providers still lack the knowledge, resources, or competencies to complete the transition to an Advanced APM. Our survey found that more than half of physicians want more APM options for their practice and many are still uncertain about their ability to effectively adopt existing APMs. Practices must reorient both their payment structures and clinical processes to enable patient-focused approaches in order to be accountable for improving outcomes in an at-risk environment. Payment models must evolve over time to fill existing gaps and create opportunities for more physicians to transition to risk-bearing payment models with appropriate financial risks and rewards.

    What tools are available to physicians to assist with the adoption of existing APMs and what processes are in place for the development of new models?

    LK: Organizations must assess their systems from a clinical, financial, and technology perspective to identify gaps and develop strategies for successful population health management approaches, reinforced by novel payment arrangements meeting the unique needs and strengths of their providers. KPMG can help prepare organizations for success under value-based payment arrangements through Medicare and other payers by assisting with the development of sustainable clinical and financial processes to improve population health, grow a clinically-integrated enterprise, and deliver improved patient outcomes.


    Sponsored By:
    Letter
    to the
    Editor

    Send us a letter

    Have an opinion about this story? Click here to submit a Letter to the Editor, and we may publish it in print.

    Sponsored Content
    Get Free Newsletters

    Sign up for free enewsletters and alerts to receive breaking news and in-depth coverage of healthcare events and trends, as they happen, right to your inbox.

    Subscribe Today

    The weekly magazine, websites, research and databases provide a powerful and all-encompassing industry presence. We help you make informed business decisions and lead your organizations to success.

    Subscribe
    Connect with Us
    • LinkedIn
    • Twitter
    • Facebook
    • RSS
    • Instagram

    Stay Connected

    Join the conversation with Modern Healthcare through our social media pages

    MDHC_Logotype_white
    Contact Us

    (877) 812-1581

    Email us

     

    Resources
    • Contact Us
    • Advertise with Us
    • Ad Choices Ad Choices
    • Sitemap
    Editorial Dept
    • Submission Guidelines
    • Code of Ethics
    • Awards
    • About Us
    Legal
    • Terms and Conditions
    • Privacy Policy
    Modern Healthcare
    Copyright © 1996-2019. Crain Communications, Inc. All Rights Reserved.
    • News
      • This Week's News
      • Providers
      • Insurance
      • Government
      • Finance
      • Technology
      • Safety & Quality
      • People
      • Regional News
        • Midwest
        • Northeast
        • South
        • West
      • Digital Edition
    • Special Features
      • Best Practices
      • InDepth Special Reports
      • Innovations
    • Transformation
      • Patients
      • Operations
      • Care Delivery
      • Payment
    • Data/Lists
      • Rankings/Lists
      • Data Points
      • Modern Healthcare Metrics
    • Op-Ed
      • Bold Moves
      • Breaking Bias
      • Commentaries
      • Letters
      • Vital Signs Blog
      • From the Editor
    • Awards
      • Nominate
      • Award Programs
        • 100 Most Influential People
        • 50 Most Influential Clinical Executives
        • Best Places to Work in Healthcare
        • Health Care Hall of Fame
        • Healthcare Marketing Impact Awards
        • Top 25 Emerging Leaders
        • Top 25 Innovators
        • Top 25 Minority Leaders
        • Top 25 Women Leaders
      • Previous Award Programs
        • Excellence in Nursing Awards
        • Design Awards
        • Top 25 COOs in Healthcare
      • Other Award Programs
        • 100 Top Hospitals
        • ACHE Awards
    • Events
      • Conferences
        • Leadership Symposium
        • Healthcare Transformation Summit
        • Critical Connections: Social Determinants of Health Symposium
        • Women Leaders in Healthcare Conference
        • Workplace of the Future Conference
        • Strategic Marketing Conference
      • Galas
        • Health Care Hall of Fame Gala
        • Top 25 Women Leaders Gala
        • Best Places to Work Awards Gala
        • Top 25 Minority Leaders Gala (2020)
      • Webinars
    • MORE +
      • Advertise
      • Media Kit
      • Newsletters
      • Jobs
      • People on the Move
      • Reprints & Licensing