The Treatspace Referral Management Blog

Insight, ideas, and resources for high-performance referral management

PCMH Redesign Reduces the Heavy Load on Reporting

Posted by Christian Kratsas on 4/20/17 1:04 PM

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Patient Centered Medical Home (PCMH) embodies the current trajectory of healthcare in that the patient is the focus of the medical model. The National Committee for Quality Assurance’s (NCQA) PCMH program is vastly adopted, with more than 12,000 practices, 60,000 clinicians, and 100 payors participating. In fact, 1 in 6 eligible physicians in the U.S. practices in an NCQA-Recognized PCMH.

With the objective to strengthen patient-provider relationships, reduce healthcare costs, and improve quality, NCQA continues to accelerate the growth of value-based care with the remodel of their PCMH program. Changes to the new PCMH model reduces the burden of the reporting process and focuses on increased healthcare quality and practice performance.

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Topics: Care Coordination, Healthcare Analytics, Value-Based Care, PCMH

The Evolving Landscape of Independent Primary Care

Posted by Christian Kratsas on 4/13/17 12:26 PM

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Independent primary and speciality care practices have challenging years ahead. MACRA, MIPS, APMs, and the ACA are posing uncertain regulations and complicated payment models.

Despite this uncertainty, there is one thing that’s clear: independent practices must prepare to take on risk in order to stay profitable.

We sat down with Mark Kissinger, executive director of Genesis Medical Associates, to get the inside scoop on the challenges a large independent primary care practice faces in a value-based care and regulatory-driven world.

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Topics: Care Coordination, Coordinated Care, Referral Network, Closed-Loop Referral Management, Value-Based Care

Half of Physicians Have Never Heard of MACRA, but They Will Soon

Posted by Jeremy Guttman on 8/4/16 6:32 PM

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Healthcare reimbursement is undergoing “the most dramatic shift in Medicare payments in the program’s 50-year history,” from fee-for-service to value-based care. But most physicians aren’t familiar with the important law that is establishing these changes for the future, the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA). Proposed details for MACRA were released by the Centers for Medicare and Medicaid Service (CMS) a few months ago, in April 2016.

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Topics: Referral Management, Value-Based Care, MACRA

Shared Accountability for Closed-Loop Referral Management

Posted by Jeremy Guttman on 5/5/16 2:05 PM

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Accountability in health care often means that primary care practices are liable for the cost and quality of a patient’s care across the continuum of care. In the old, diminishing fee-for-service reimbursement system, practices were only reimbursed based on actions within their own office.

Now, in new reimbursement models like ACOs, PCMHs, risk-based contracting, and alternative payment models, shared accountability is king.

“The idea that you are accountable for what happens after people leave your office is no longer just a philosophical discussion. It's dollars and cents.”1

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Topics: Referral Management, Closed-Loop Referral Management, Provider Accountability, Value-Based Care