Tag: quality payment program

Teaching patients portal usage improves satisfaction, engagement

 

 

Dive Brief:

  • Teaching patients how to access a patient portal and its role in their post-discharge care increases engagement during and after hospitalization. It also improves patient experience, a new JAMIA study finds.
  • Researchers gave digital tablets to 97 patients for one day, showing them how to register and log in to the patient portal. Of those, 50 also received a bedside tutorial on key functions of the portal and the importance of those functions in their transition to follow-up care.
  • Patients in the intervention group had a higher mean number of logins (3.48 versus 2.94) than controls. They also had a higher mean number of specific portal tasks than controls, though no individual comparison was statistically significant. Those in the test group had an easier time logging in and navigating the portal and were generally happy with the tablet approach — 88% reported being satisfied or very satisfied.

Dive Insight:

As MACRA and the Quality Payment Program place more emphasis on patient access to information, patient portals provide an effective means of engaging patients and improving outcomes.

And patients have indicated they want more communication from their doctors. In a recent Aetna report, 77% of consumers said it is very important for them to speak to them in easy-to-understand language and 59% would like access to other healthcare professionals to coordinate care. Younger consumers also expressed a high interest in digital tools to improve communication with providers.

While previous interventions have focused on engaging providers to improve completion of key tasks during transitions of care, this is the first randomized clinical trial to assess patient engagement as a way to increase portal use in and outside the hospital, the authors note.

The fact that the intervention took just 15 minutes to deliver made it “highly feasible and consistent to patients,” they say.

Still, while use of the hospital’s tablets increased engagement, the uptick was not significant in most instances, perhaps due to unfamiliarity with the devices, they suggest. Teaching patients to access the portal on their own devices could perhaps boost efficacy even more.

“As the movement towards ‘bring your own device’ (BYOD) gains momentum for patient engagement with the EHR and other health-related platforms (eg, diet, activity, and medication logs or other health-related apps), there is tremendous opportunity for patient in acute and post-acute phases of care,” the authors write.

Future research should explore use of BYOD, such as whether personal devices could facilitate stored credentials and use of biometrics to log in to patient portals, they say. More research on portal use in hospitals is also needed, “especially given that most hospitals have not yet deployed this feature of EHR, and Meaningful Use will require higher use in the near future, suggesting an impending implementation boom — more evidence is needed to guide this process,” they write.

Also needed is research on the ability to share data among disparate systems and how that affects use of portals when patients receive care at multiple institutions.

Most ACOs Would Leave MSSP if Forced Into Risk, Survey Finds

Most ACOs would leave MSSP if forced into risk, survey finds | DAS Health

Nearly three-fourths of accountable care organizations will leave the Medicare Shared Savings Program next year if they are forced to assume risk, according to a new survey by the National Association of ACOs.

Of the 82 ACOs the group surveyed, 71% said they will likely exit the MSSP if they have to start taking on risk. About 6% said they are unsure, while 23% indicated they would likely remain in the program.

Under the Affordable Care Act, ACOs that entered MSSP Track 1 in 2012 or 2013 are expected to convert to a risk-based model in their third contract period, which starts next year.

“These results paint a bleak future of what will happen if the government keeps its mandate to push ACOs into risk,” Clif Gaus, president and CEO of NAACOS, said in a statement. “It’s naive to think ACOs that aren’t ready will be forced into risk in what is ultimately a voluntary program. The more likely outcome will be that many ACOs quit the program, divest their care coordination resources and return to payment models that emphasize volume over value.”

While the survey involved just those ACOs that will face risk requirements next year, the fallout from forcing risk on ACOs will be an ongoing issue as more of them approach their third agreement periods, NAACOS warns.

ACOs’ reasons for not being prepared to assume risk varied. The three top challenges cited were the amount of risk assumed, the possibility of unexpected changes to the ACO model or CMS rules, and the desire for more predictable financial projections.

NAACOS wrote to CMS Administrator Seema Verma in February, urging the agency to allow some ACOs to remain in Track 1 for a third contract period before shifting to a two-sided risk model. The exception would apply to ACOs that generate net savings across four performance years, ACOs that score at or above the 50th percentile in quality in two of three pay-for-performance years and ACOs that improve their overall quality score by 10 or more percentage points over their pay-for-performance years.

Providers’ lack of willingness to take up risk is a pervasive problem for the value-based care movement.

Studies have showed mixed results with ACOs. A recent analysis by Avalere found the MSSP missed federal cost-savings projections from 2010, when the ACA was enacted, by a wide margin. The Congressional Budget Office estimated the program would save Medicare $1.5 million from 2013 to 2016. Instead, it raised federal spending by $384 million, Avalere said.

A pair of studies published last year in JAMA Internal Medicine were more favorable. In one study, post-acute spending at 114 ACOs dropped 9% from 2012 to 2014. The other study showed savings at two ACOs in Colorado and Oregon, despite major differences in their structures.

Medicaid Meaningful Use for the Aprima EHR User 4.18.2018

The Medicaid Meaningful Use Webinar will review the 2018 Medicaid EHR Incentive Program (Meaningful Use) Objectives and Measures in the Aprima EHR.

 

Recommended attendees:

  • – Office manager
  • – Clinical staff and/or providers responsible for reporting

 

 

 

Advancing Care Information for the Aprima EHR User 4.11.2018

The Advancing Care Information (ACI) for the Aprima User Webinar will review each measure of the 2018 Advancing Care Information Objectives, Measures and how to meet them in the Aprima EHR.

 

Recommended attendees:

  • – Office manager
  • – Clinical staff and/or providers responsible for reporting

 

 

 

Advancing Care Information for the Aprima EHR User 3.29.2018

The Advancing Care Information (ACI) for the Aprima User Webinar will review each measure of the 2018 Advancing Care Information Objectives, Measures and how to meet them in the Aprima EHR.

 

Recommended attendees:

  • – Office manager
  • – Clinical staff and/or providers responsible for reporting

 

 

 

CMS Plans MACRA Changes to Improve Flexibility, Lessen Burden

CMS plans MACRA changes to improve flexibility, lessen burden

CMS is looking to overhaul MACRA and remove reporting barriers for quality measures, according to the Healthcare Financial Management Association.

Dr. Kate Goodrich, director of the Center for Clinical Standards and Quality, said the agency is reviewing all quality measures under MACRA to determine if there are ways to “automatically extract required quality data from electronic records” that will relieve physicians needing to report such data.

Goodrich, the agency’s CMO, said CMS isn’t turning back from the move to value-based payments and plans to launch more alternative payment models (APMs) this year.

RELATED: It’s not too late for 2017 submission assistance. Avoid penalties with consulting assistance plans – hurry, must submit Quality Payment Program data by March 31.

Goodrich said CMS doesn’t expect these efforts will delay implementing MACRA requirements in 2019.

Physicians will likely rejoice at the news that CMS is looking to make it easier to report quality data and adding APMs. Removing regulatory burdens and offering providers more choices are some of Trump administration’s healthcare goals.

One common complaint about MACRA is that it’s too burdensome for smaller practices. The CMS decided last November not to require smaller practices to take part in MIPS. However, large systems have voiced similar concerns about MACRA’s demand on larger systems.

The Medicare Payment Advisory Commission also recommended repealing the payment track for MIPS. The group, which offers advice to Congress, instead recommended withholding about 2% of payments for physicians not in an APM. Providers who join an APM would have the chance to recover the withheld amount under MedPAC’s proposal.

The CMS is well aware of problems with reporting data. The agency recently said it is asking clinicians to take part in a year-long study looking into the burden of reporting data for MIPS.

The agency is also testing whether MACRA and physicians in MIPS can reduce Medicare spending. The pilot test will analyze costs connected with eight procedures and medical conditions, including percutaneous coronary intervention, knee arthroplasty, cataract removal, lower limb revascularization, colonoscopy, intracranial hemorrhage and pneumonia.


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