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March 30, 2017

ACO roundup: CMS rethinks ACO doctor-patient pairing

Daily Briefing
  • How Intermountain is predicting patients' chronic disease risk. Intermountain Healthcare has developed a newtestthat predicts which patients will develop chronic conditions. Researchers say the test—Intermountain Chronic Disease Risk Score, or ICHRON—can predict which patients will be diagnosed with chronic conditions within three years of when the test is performed with about 78 percent accuracy. The tool uses patients' ages and results from traditional blood tests to determine their risk score.

  • Health care groups push CMS to relax meaningful use requirements. The Medical Group Management Association, American Medical Association, and a number of other health care organizations are calling on CMS to reduce the burden and penalties associated with EHRs, meaningful use, the Physician Quality Reporting System (PQRS), and Physician Value-Based Payment Modifier (PVBM). In a letter to CMS Administrator Seema Verma, the groups wrote, "We urge the Administration to take a series of steps to address challenges in [meaningful use], PQRS, and PVBM prior to their replacement by MACRA and minimize the penalties assessed for physicians who tried to participate in these programs." Specifically, the groups asked CMS to create a new category of hardship exemptions for administrative burdens, not penalize providers for not meeting "arbitrary" requirements, and provide relief to providers who have been penalized in the past.

  • CMS rethinks ACO doctor-patient pairing. CMS is moving to increase patient and provider participation in ACOs by automatically pairing patients with doctors. Patients enrolled in an ACO will soon be able to go to a website, input their primary care doctor, and be paired with that doctor—if possible—starting next year. Terri Postma, a medical officer at CMS, said, "ACOs have told us they prefer to know with more certainty at the beginning of the performance year what beneficiaries the CMS will hold them accountable for." However, some provider groups such as the American Academy of Family Physicians worry the process will still be too complicated for some beneficiaries. 

From Advisory Board:

  • Taking on overdiagnosis waste and harm. Join us on April 18 at 1 P.M. ET for a discussion with MemorialCare's Dr. James Leo and Dr. Helen Macfie on when to challenge the default inclination of treating many to benefit few. ·        

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  • Combating physician burnout. The unrelenting pace of change in today’s health care landscape is leading to record levels of physician burnout. Join us on April 18 at 3 P.M. ET to learn how to identify the key drivers of burnout at your organization and mitigate further detriment to your physicians, your patients, and your business.

Register for the webconference

Register for the webconference

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