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    Top 10 challenges facing physicians in 2018

     

    5. Managing quality measure incentives / disincentives

    The Centers for Medicare & Medicaid Services (CMS) recently released its final rule governing its Medicare Quality Payment Program in 2018. 

    While the final rule did not deviate significantly from the proposed rule released in June, there was a major change for those eligible for participation in the Merit-based Incentive Payment System (MIPS)—beginning in 2018 the cost category, based on claims data, becomes 10% of eligible physicians’ final MIPS score. 

     

    RELATED READING: Physicians struggle to manage quality measures

     

    This represents a major change from the proposed rule, which kept it at 0% next year. CMS will calculate cost through Medicare Spending per Beneficiary (MSPB) and total per capita cost measures for 2018—carryovers from the Value Modifier program.

    The change will affect physicians—who already report struggling with managing quality measures and the incentives and disincentives that come with it—in a major way. 

    “Physicians are supplying data, but it stops there,” Owen Dahl, MBA, FACHE, a practice consultant, tells Medical Economics. Getting little direction from CMS “is a universal frustration for all offices I talk with.”

    So, what can physicians do to make quality measure reporting easier?

    Focus on what you do well

    Because physicians and practices are allowed to pick the measures used to evaluate them, they should examine the menu and figure out where they might do well, says Cristina Boccuti, MA, MPP, associate director of the program on Medicare policy at the Kaiser Family Foundation. 

    Consider areas of improvement

    Eric Schneider, MD, FACP, formerly a practicing internist and now a senior vice president for policy and research at The Commonwealth Fund, advises physicians to think about the selection of measures where there is room for improvement over time.

    Think about type of clinical care

    By selecting measures that accurately reflect the types of clinical care they most commonly provide, physicians will have sample sizes large enough to be statistically significant, Schneider says. 

    Range of quality measures does matter

    According to Harold Miller, president and chief executive officer of the Center for Healthcare Quality and Payment Reform, physicians should ensure that the range of quality measures they choose is broad. The proposed list of quality measures “doesn’t even come close to being able to address the various types of patient conditions and the different needs of patients,” he says. “You wind up with a lot of those measures being designed for patients with only one health problem and don’t work well for those with multiple health problems.” 

    To better understand the Medicare Quality Payment Program, visit bit.ly/18-MACRA

    Next: Costs as barriers to patient adherence

    joseph-rose-cuyahoga-engagement-photographer-065.jpg
    Rose Schneider Krivich
    Rose is the content specialist for Medical Economics.
    Todd Shryock
    Todd Shryock, contributing author

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