Inside Medicare's New Payment System

Under MACRA, most physicians will participate in a value-based payment program known as MIPS, which stands for Merit-based Incentive Payment System. Beginning with the 2019 physician fee schedule, MIPS will replace the Physician Quality Reporting System, Value-Based Modifier, and Meaningful Use of electronic health records programs. Ms. Laura Hoffman, Assistant Director in the Department of Federal Affairs at AMA, provides an overview of the Clinical Practice Improvement Activities, or CPIA, category, including how the activities may be reported and scored by CMS. Please click here for a full list of CMS' proposed CPIAs Update as of September 2017: CMS shortened the category name to “improvement activities”. The content provided here is otherwise still accurate and up-to-date.

Host: Matt Birnholz, MD Guest: Robin Zon, MD, FACP Value-based, patient-centered care has become the destination for all branches of medicine, and is the philosophy driving modern payment reform initiatives like MACRA. But the unique care delivery needs in each specialty challenge the notion that one payment model can serve everyone. And nowhere has this become more relevant than in the field of oncology. Dr. Matt Birnholz joins Dr. Robin Zon, practicing oncologist and vice president and senior partner at Michiana Hematology-Oncology in South Bend, Indiana. Dr. Zon serves as Chair-Elect of ASCO's Government Relations Committee was Past Chair of the Clinical Practice Committee, which alongside other stakeholders at ASCO developed a Patient-Centered Oncology Payment (PCOP) model. Recently, Dr. Zon presented this information at the recent AMA House of Delegates meeting in June. She speaks to the phases of this model, how it can function as a defined APM under MACRA, and its demonstrated positive impacts o

Host: Matt Birnholz, MD Guest: Lawrence Kosinski, MD The advancement of the Medicare Access and CHIP Reauthorization Act (MACRA) has catapulted Alternative Payment Models into the spotlight for identifying new value-based approaches to care. But questions persist as to the roles that specialists can and should play in the design and implementation of APMs, how these models will cut healthcare costs, and which administrative partnerships are needed to make them successful. Dr. Lawrence Kosinski, a practicing gastroenterologist with The Illinois Gastroenterology Group, is pioneering one such APM that applies an innovative method for tracking patients between clinic visits. The model, called SonarMD, for which Dr. Kosinski is founder and Chief Medical Officer, provides a web-based platform that pings patients beyond practice settings to help get ahead of issues before they become emergencies.