12Apr2019

Bundled Payments – Last Call???

The following was originally published on healthcareITToday.com.   Medicare’s Bundled Payment for Care Improvement (BPCI) program has seen more ups and downs than the stock market. Here we go again! CMS seems to be pulling another about-face on Bundled Payments. Here is what I wrote in a blog post about the program back in November 2018.
“The Obama administration launched the programs and went through four models including a mandatory model (Joint Replacement). The first two Secretaries of HHS in the Trump administration decided that they didn’t like bundled payment programs and canceled two upcoming mandatory programs (care for heart attacks and for cardiac bypass surgery). ... read more

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21Mar2019

Getting Ready for Bundled Payments: On Your Mark. Get Set. Go.

By: Dr. Mansoor Khan So you have decided to join the bundled payments train, now what? CMS has not yet announced the dates for when the application period will start and what the other associated dates will be. But we do know that the start date for the next BPCI Advanced program will be Jan 1, 2020. If we assume that the application process will follow the same timeline as 2018, we can expect the application portal to be open in late March or early April. There are a number of things that you do right now that will help you be ready to apply for, launch, and successfully manage your BPCI-A program. Required activities can be grouped into two categories: what you need to do to prepare to apply, and what are the tasks you’ll need to accomplish to successfully run your BPCI-A program. Figure 1, below, lists both the high-level activities that will need to be performed as well as the recommended order and duration of each ... read more

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Categories: care management, clinical decision Support, Healthcare, HealthIT, Improve Patient Care, patient engagement, population health, Reduce Healthcare costs
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20Nov2018

Bundled Payments: How to make a million dollars without doing any more work!

By: Dr. Mansoor Khan Medicare’s Bundled Payment for Care Improvement (BPCI) program has seen more ups and downs than the stock market lately. The Obama administration launched the programs and went thru 4 models including a mandatory model (Joint Replacement). The first 2 Secretaries of HHS under Trump decided that they didn’t like bundled payment programs and canceled 2 upcoming mandatory programs (care for heart attacks and for cardiac bypass surgery) but allowed the voluntary BPCI Advanced program to go forward. The 3rd HHS Secretary (Alex Azar) has now just announced that they will be launching 3 new mandatory bundles because, as he put it “BPCI Advanced is a voluntary model, where potential participants can select whether they want to join. But we’re not going to stick to voluntary models. Real experimentation with episodic bundles requires a willingness to try mandatory models. We know they are the most ... read more

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14Nov2018

PERSIVIA SELECTED BY PRIME HEALTHCARE TO PROVIDE BUNDLED PAYMENT SOLUTION TO 34 HOSPITALS FOR BPCI ADVANCED SUPPORT

Marlborough, MA — Nov. 14, 2018 — Persivia, a provider of real-time bundled payment, value-based care, population health and quality management solutions,announced today that Prime Healthcare, a leading operator of over 50 hospitals nationwide, has selected Persivia’s Bundled Payment solution for its BPCI Advanced program requirements.

solution consists of the industry’s only end to end solution for succeeding in bundled payment programs. Built around our industry leading AI engine, Soliton, the solution provides:

  • Analytics for helping design bundled payment programs and selecting Episode Initiators and Episode Groups
  • Redesign and manage care across the full spectrum with Real Time Care Alerts that can identify attributable patients at admission and then follow them thru the acute and post-acute ... read more

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15Aug2018

Persivia partners with athenahealth to support quality measurement across its hospital client base

LOWELL, MA — Aug. 15, 2018 — Persivia, a provider of real-time quality and care management solutions, announced today that athenahealth, a leading provider of network-enabled services for hospital and ambulatory clients nationwide, has selected Persivia’s e-CQM (clinical quality measure) solution for its IQR program requirements. The Drummond-certified program will enable athenahealth to continue to satisfy both current and upcoming e-CQM requirements.

Persivia’s e-CQM solution consists of the reporting service and an Executive Dashboard. Because the system is tightly integrated into athenahealth, customers benefit from a continuous stream of data which enables them to monitor their quality performance throughout the year, all without additional cost to their organization.

Persivia is committed to bringing solutions to hospitals and providers that help them achieve their regulatory, quality and financial goals. ... read more

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03Aug2018

Changes to MIPS announced in the 2019 QPP Proposed Rule

The proposed rule for the 2019 Quality Payment Program (QPP) includes several changes to the Merit-Based Incentive Payment System (MIPS) that aim to reduce the administrative burden for eligible clinicians and put more emphasis on the improving EHR interoperability. In 2017, 91% of MIPS eligible clinicians successfully participated, thus giving CMS the encouragement to continue increasing the program requirements. At the same time, CMS has maintained certain measures of flexibility, particularly for small practices. Enacted earlier this year, the Bipartisan Budget Act of 2018 provides additional authority to continue the gradual transition in MIPS for three more years, to help further reduce clinician burden. The 60-day comment period during which CMS will receive public comments and recommendations ends on September 10th, 2018, with the final rule expected to be published in fall.

Key Highlights from the Proposed ... read more

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13Jul2018

Care Management 3.0 : Increase Revenue & Improve Quality while providing the best care

The current healthcare environment has brought about a new unique set of challenges.  Patients are becoming more tech-savvy with their smartphones, tablets, and computers, they tend to demand “What they want when they want it, and how they want it!”.  This becomes especially difficult to balance with the Quality Programs like MIPS, MACRA, CPC+, etc. becoming more stringent every year.  It has become difficult for Providers to balance patients’ needs with providing a high quality of care all the while keeping an eye on rising healthcare costs.  This becomes even more challenging with Quality Programs like MIPS, MACRA, CPC+, etc. becoming more stringent every year.

 

In the past, ... read more

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Categories: care management, Healthcare, HealthIT, Improve Patient Care, New Revenue Streams, patient engagement, population health, Webinar
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06Jun2018

What healthcare can learn from the retail apocalypse

By: Dr.Mansoor Khan   The retail industry is going thru what can rightly be called an apocalypse. Almost 7,000 retail outlets shut down in the US in 2017! In the meanwhile, these retailers opened almost 1,500 new stores!
  • Dollar General: 900
  • Dollar Tree: 320
  • Aldi: 180
  • Target: 35
  • Walmart: 25
  • Costco: 3
This is true across all major retail verticals from home goods to grocery to fashion (source: CBInsights). With the recent seismic shifts in the healthcare industry, we anticipate that this sector will also face a similar shift in the not too distant future. So what do we do about it? As the retail success stories illustrate and as we started to talk about in the last blog, the answer lies in giving the customer what they want. Healthcare, fortunately, has a big advantage; 88% of patients give their ... read more

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Categories: Artificial Intelligence, care management, clinical decision Support, Decision Support, Healthcare, HealthIT, Improve Patient Care, Industry News
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03Jun2018

CPC+ 2018 updates you should know!

By Zaeema Ahmed I am excited to bring you the updates you need to know for 2018 and some of the lessons learned from 2017. To begin with, CMS has increased the number of eCQMS from 14 to 19 measures. The measure set contains 7 new measures and two measures have been retired. For 2018, you must successfully report 9 measures and (this is important) the two outcome measures (Controlling High Blood Pressure and Diabetes HbA1c) are mandatory. As eCQMS are at the heart of meeting CPC+ quality requirements, we are happy to report that CMS has kept the benchmarks at the 30th and 70th percentiles and the measure thresholds remain the same. To be able to retain your PBIP payment, you still need to meet the 30th percentile for all 9 and the 70th percentile for at least 7 of the 9 measures. One of the lessons learned is that to achieve an optimal performance start early on tracking and monitoring these measures. A follow-on lesson being: Pay ... read more

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Categories: care management, CPC plus, Healthcare, HealthIT, Industry News, patient engagement
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17May2018

Patient Engagement – the Urgent Care killer?

By Dr. Mansoor Khan Last month, we started looking at the impact of Urgent Care centers on physician practices. I only started there because a news article had caught my eye. There are, however, multiple other reasons for the steadily declining revenues and squeezing profit margins of physicians. These include payer payment transformation and value-based purchasing initiatives, patient demand for more convenient care delivery modalities, quality incentives/penalties, unfilled practice calendars (27% of available slots go unfilled), losing patients to competitors, to name a few. The response to these conditions however, can’t be more of the same (remember what Einstein said, no not “The hardest thing to understand in the world is the income tax”, though he did say that, but rather “We can't solve problems by using the same kind of thinking we used when we created them.”). So, to survive and thrive practices ... read more

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Categories: care management, Healthcare, HealthIT, Improve Patient Care, patient engagement, Urgent Crae
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