Bridges to Excellence (BTE)
Bridges to Excellence (BTE) is a not-for-profit organization developed by employers, clinicians, health care services, researchers, and other industry experts with a mission to create significant leaps in the quality of care by recognizing and rewarding health care providers who demonstrate that they have implemented comprehensive solutions in the management of patients and deliver safe, timely, effective, and patient-centered care. Bridges to Excellence will work with payers and employers to provide a incentive to physicians who are Bridges to Excellence Recognized. (Updated July 2016)
Harris County Hospital Survey
The Harris county Medical Society (HCMS) is committed to serving the needs of our physician members as they care for their patients and improve the health of our community. Since much of that care is delivered in area hospitals, HCMS conducted a survey to determine physicians' perspective and satisfaction in their relationships with local hospitals. Over 2000 physician surveys were received that provided statistically valid results for 30 hospitals. The results should generate dialogue and improve the overall quality of care across all of Houston's hospitals. Click here to read more from the HCMS President, Dr. Kimberly Monday, and to find out how to request your copy of the survey for a hospital(s) of your choice.
Medical Cultural Awareness and Health Literacy
The ability to effectively and clearly communicate with patients can dramatically improve clinical outcomes. Clear communication encompass a knowledge of the spoken language as well as medical cultural awareness. For physicians practicing in Houston and Harris County, more than 90 languages are spoken throughout the Houston area. A recent report from the Rice University Kinder Institute for Urban Research indicates Houston has become the most racially and ethnically diverse metropolitan area in the nation, surpassing New York metropolitan area.
MACRA and Medicare Payment Reform - Physician Resources
On May 9, 2016 CMS took it's first step forward to implement several critical provisions of The Medicare Access and CHIP Reauthorization Act of 2015 (aka MACRA) with the release of proposed regulation titled "Medicare Program; Merit-Based Incentive Payment System (MIPS) and Alternative Payment Model (APM) Incentive under the Physician Fee Schedule and Criteria for Physician Focused Payment Models." (Updated October 2016)
- Merit-Based Incentive Payment System (MIPS) - In the law that repealed the Medicare Sustainable Growth Rate (SGR) physician payment methodology, a new payment framework was established consisting of stable fee schedule updates, a new Merit-Based Incentive Payment System (MIPS), and incentives for participation in qualifying alternative payment models (APMs).
- 2017 MIPS - How to Avoid the Penalty - 2017 is the first performance year for MIPS. This first year is considered a transition year where CMS has offered a quick and easy submission option to avoid the -4% penalty in 2019.
- Alternative Payment Models (APMs) - MACRA, practices can propose alternative payment models (APMs) to the Centers for Medicare & Medicaid Services (CMS) that accept two-sided financial risk and use electronic health records and quality measures. “Qualifying APM participants” will not be subject to MIPS adjustments and will receive a lump sum incentive payment equal to 5 percent of the prior year’s estimated aggregate expenditures under the fee schedule. The 5 percent incentive payment is available from 2019 to 2024, but beginning in 2026, the fee schedule growth rate will be higher for qualifying APM participants than for other practitioners. Accountable Care Organizations (ACOs), Patient Centered Medical Homes, and bundled payment models are some examples of APMs. Eligible APMs will be defined by CMS. Proposed rules should be released in Spring 2016.
Providing great patient experience can help a physician grow his/her practice by cultivating patient loyalty and retention. Patient experience encompasses a wide range of issues including cultural competency, health disparities, health literacy, patient satisfaction. In addition, in today’s consumer-driven health care environment, payment may soon be dependent on measuring patient satisfaction.
Online health information combined with social media channels like Twitter and Facebook has created a new generation of patients. They are empowered. They have a voice in their own care that they never had before. And more are using social media and physician review sites to choose their doctor or medical practice. Given these stakes, physicians can’t afford to leave their online reputation to chance.
The Physician Quality Reporting System (PQRS) is Medicare’s national initiative to reward physicians based on quality. All 2016 reporting deadlines have passed. 2016 was the final year to report to this program. (Updated April 2017)
- Quality Resource and Usage Report (QRUR) Report: The Value-Based Payment Modifier Report Card. This report is designed to help physicians and group practices understand their cost and quality assessments under the VBPM and how they performed relative to their peers, CMS released two types of QRUR reports annually. 2016 reports will not be available until late 2017.
- PQRS Feedback Report - This report tells you whether you successfully submitted your PQRS Report and whether you are subject to the negative payment penalty. PQRS Feedback Reports for program year 2014 and later can be accessed (when available) from the PQRS Portal. Instructions for access are found in the PQRS Portal User Guide. 2016 reports will not be available until late 2017.
Quality health care can be defined as the extent to which patients get the care they need in a manner that most effectively protects or restores their health. This means having timely access to care, getting treatment that medical evidence has found to be effective and getting appropriate preventive care. Quality Improvement (QI) is a formal approach to the analysis of performance and efforts to improve patient care.
Created by HCMS | Edited October 2016