Pennsylvania health systems work with CMS to implement value-based payment system.
The Centers for Medicare & Medicaid Services (CMS), currently initiating new practitioner payment systems, requests input from health care professionals regarding criteria for determining physician payments per a new federal law.
Pennsylvania hospitals and health systems will be updated by The Hospital & Healthsystem Association of Pennsylvania (HAP) as it coordinates communication with practitioners to bring consistent quality of care to all patients and consumers during the period of modification.
CMS — with offices in Baltimore and Washington, D.C. — released a draft of its Quality Measure Development Plan to smooth the transition to the new system, which will be based primarily on the quality of care rather than the numerical measurement of services and which was mandated by the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA).
MACRA will phase out three existing payment criteria — the physician quality reporting system, value-based payment modifier and meaningful use — while incorporating relevant portions of those measurements into the new Merit-Based Incentive Payment System (MIPS). In addition, an Alternative Payment Model (APM) system is under consideration.
Expected standards of focus include four aspects of care: person and caregiver-centered experience of care; patient-reported outcomes and patient health outcomes; communication and care coordination; and appropriate resource use.
CMS encourages comments and questions by March 1.
HAP will continue to monitor the changeover.
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