Inside Medicare's New Payment System

Guest: Patrice Harris, MD Guest: Frank Dowling, MD Guest: Elizabeth Salisbury-Afshar, MD Guest: Sharon Levy, MD, MPH Guest: John Renner, MD As the nation’s opioid epidemic has now become a deadlier drug overdose epidemic, the AMA Opioid Task Force urges individualized and evidence-based patient care for those with a substance use disorder. Offering their unique perspectives on how to help patients, physician members of the AMA Opioid Task Force shared their perspectives on helping patients with a substance use disorder. Drs. Patrice Harris, Frank Dowling, Elizabeth Salisbury-Afshar, Sharon Levy, and John Renner.

Guest: David Ring, MD, PhD Guest: Ameet Nagpal, MD Guest: Steven P. Stanos, Jr., DO Individualized healthcare is extremely important for patients with pain, but physicians and patients face barriers for such care. Drs. David Ring, Ameet Nagpal, and Steven Stanos sat down with us to provide insight on how the 2019 AMA Opioid Task Force is working to support individualized care for patients with pain.

Host: Matt Birnholz, MD Guest: Barbara Levy, MD Guest: Peter A. Hollmann, MD In response to physicians’ feedback, the Centers for Medicare and Medicaid Services proposed some big changes to the documentation guidelines for office visits. But is there still room for improvement? Co-chairs of the American Medical Association’s CPT/RUC Workgroup on Evaluation and Management Services Dr. Peter Hollmann and Dr. Barbara Levy join Dr. Matt Birnholz to discuss the Workgroup’s effort to further simplify the work of the healthcare provider and improve the health of patients nationwide.

Host: Matt Birnholz, MD Guest: Barbara A. McAneny, MD There were a lot of changes made to the 2019 Medicare payment policies. Here to review what these updates mean—and what’s being done in response to them—is Dr. Barbara McAneny, President of the AMA.

Host: Jennifer Caudle, DO Guest: Mark Friedberg, MD With the use of alternative payment models (APMs) on the rise, the American Medical Association and the RAND Corporation joined forces to investigate the impact of APMs on physicians across the country. So what exactly did the study uncover? Diving into the study’s findings with Dr. Jennifer Caudle is Dr. Mark Friedberg, senior physician policy researcher at RAND and director of its Boston office.

Host: Matt Birnholz, MD Guest: Koryn Rubin Some big changes are taking effect in one of the performance categories under MIPS. The cost category is now affecting your MIPS score differently, and here to make sure you don’t fall behind is Koryn Rubin, Assistant Director of Federal Affairs at the American Medical Association.

Host: Matt Birnholz, MD Guest: Carol Vargo, MHS Amid all the changes to quality reporting under MIPS, many hospital-based physicians are unsure about what effects, if any, there will be to their employment and compensation. Luckily, there are experts to help break down everything from performance-based changes to compensation accuracy, and providing a how-to guide for navigating the Quality Payment Program in the hospital setting is Carol Vargo, Director of Physician Practice Sustainability at the AMA.

Host: Matt Birnholz, MD Even though more and more physicians are becoming aware of the option to participate in the Quality Payment Program as a virtual group, many still may not have all the details needed to decide whether this is right for them—or how they can even go about joining one. To help clarify the confusion, Dr. Matt Birnholz is joined by Ashley McGlone, Washington Counsel for the AMA.

Host: Matt Birnholz, MD Alternative Payment Models, or APMs, were introduced as a way to reduce costs and improve patient care, but physicians have been slow to adopt this model. To address this issue, Dr. Matt Birnholz connects with Harold Miller, President and CEO of the Center for Healthcare Quality and Payment Reform, who provides the details that physicians need to know regarding APMs and why Physician-Focused Payment Models could be the solution.

Host: Shira Johnson, MD Guest: Laura Hoffman Guest: Matt Reid If you’re planning on participating in the Quality Payment Program in 2019, you may be wondering what you can—and should—be doing now to prepare for upgrading your electronic health records, or how this update could affect your computers and networks. If so, you’re not alone. To help guide you through this process, Dr. Shira Johnson is joined by two AMA staff—Senior Health IT Consultant Matt Reid and Assistant Director of Federal Affairs Laura Hoffman—who answer these and other FAQs.

Host: Matt Birnholz, MD Guest: Koryn Rubin With more and more physicians wondering what the new individual and group reporting measures mean for them and their practice, Dr. Matt Birnholz sat down with Koryn Rubin, Assistant Director of Federal Affairs at the American Medical Association, to break down these options.

Host: Matt Birnholz, MD Guest: Richard Deem With the advent of the Medicare Quality Payment Program, there are notable practice changes for clinicians. What do these changes mean for you and your practice? To examine the issues and opportunities, host Dr. Matt Birnholz welcomes Richard Deem who is the Senior Vice President of Advocacy at AMA. Mr. Deem will explain how these changes affect small practices in particular, and what physicians in these practices need to know in order to succeed.

Host: Matt Birnholz, MD New rules issued by the Centers for Medicare and Medicaid Services are providing physicians with a smoother transition to the Quality Payment Program, or QPP. One critical part of this support involves technical assistance programs, which provide information and resources to physicians during and after this transition. Host Dr. Matt Birnholz talks with Dr. Edward Sobel and Ms. Temaka Williams about what technical assistance is available to physicians navigating the quality payment program. Dr. Sobel is the Medical Director at Quality Insights,which is based in Charleston, WV, while Miss Williams is a Health Information Technology Advisor at Telligen Oak Brook, Illinois.

Host: Matt Birnholz, MD A recent survey of one thousand practicing physicians in the US, conducted by KPMG and the American Medical Association, is shedding new light on knowledge gaps in preparing for MACRA and the Quality Payment Program, and what can be done to address those gaps moving forward. Dr. Matt Birnholz speaks with Larry Kocot, Principal at KPMG and National Leader of the Center for Healthcare Regulatory Insight. Ross White, Manager for KPMG’s Center for Healthcare Regulatory Insight, and Carol Vargo, Director of Physician Practice Sustainability in the AMA Physician Satisfaction and Practice Sustainability Strategic Initiative Group about the results of this survey.

Host: Matt Birnholz, MD This discussion is dedicated to helping clinicians understand the “Pick Your Pace” option for Merit-Based Incentive Payment System (MIPS) participation.How should physicians navigate these new reporting options to avoid any payment penalties, and what are the most effective first steps? Host Dr. Matt Birnholz welcomes Dr. Kate Goodrich, Director of the Center for Clinical Standards and Quality under the Centers for Medicare and Medicaid Services. Dr. Goodrich also serves as CMS's Chief Medical Officer.

Host: Matt Birnholz, MD MACRA’ is one of the hottest buzzwords in clinical medicine and health policy today. But in a fast-changing legislative landscape, questions arise on the current and future directions for MACRA, as well as best practices for all of us going forward. Host Dr. Matt Birnholz talks with AMA Washington Counsel, Ashley McGlone and Laura Hoffman, Assistant Director of Federal Affairs, about the top questions on MACRA that everyone wants to know.

Host: Matt Birnholz, MD The new Quality Payment Program, QPP, created by Medicare Access and CHIP Reauthorization Act, or MACRA, has generated questions from the physician community regarding how to participate, and what that participation will mean for benefiting practices. On this episode, we’ll investigate physician-focused alternative payment models, or APMs, and their emerging role in this new Quality Payment Program. Host Dr. Matt Birnholz welcomes Sandy Marks, Assistant Director of Federal Affairs at the American Medical Association to discuss APMs.

Host: Matt Birnholz, MD Qualified Clinical Data Registries, or QCDRs, are keys to Medicare’s new payment system in that they collect clinical data for the purpose of patient and disease tracking. But what do we need to know about QCDRs, where to find them, the requirements for successful reporting and why they are so important for clinical practices? Host Dr. Matt Birnholz welcomes a panel of QCDR experts from the AMA. Dr. Kathleen Blake, Vice-President, and Lance Mueller, Manager, both serve as part of the AMA group that works on payment reform and healthcare quality. Koryn Rubin serves as Assistant Director of Federal Affairs at the AMA.

Ms. Koryn Rubin provides an overview of the reporting options under the Merit-Based Incentive Payment System (MIPS), specifically related to the quality performance category. After listening to this podcast, physicians should obtain a basic understanding between reporting as an individual or reporting as a group practice under MIPS. Ms. Rubin is Assistant Director of Federal Affairs at AMA. Program requirements are subject to change. The links below are intended to assist with MIPS preparation and are informational only.

EHRs have made a significant impact in the practice of medicine across the country. While many improvements in the usability, flexibility, and interoperability of EHRs are needed, the use of an EHR can still be beneficial for many physicians. Matt Reid, MS provides you with information about the importance of electronic health records (EHRs) to participation in MACRA. Mr. Reid is a Senior Health Care IT Consultant at the AMA. You can find more information about certified EHRs at the Office of the National Coordinator's Certified Health IT Product List.