America's Physician Groups’ Post

If you missed this webinar discussing our most recent research with Harvard Medical School on the impact of Medicare Advantage plan design on health outcomes among various types of Medicare enrollees I am sure you will find it informative. Better still it is moderated by Susan Denzer, President of Americas Physician Groups and if you know Susan you know she always brings keen insights, perspective, and questions. Please reach out if you want to learn more about our work exploring differences between traditional Medicare and Medicare Advantage. #Medicare #MA #FFS #benefitdesign #outcomes #quality #inovalon

Very interesting study regarding Medicare patients and who chooses MA plans vs MFS plans. See the details below.

Yesterday, lawmakers released a health care funding package that includes a one-year extension of Medicare's advanced alternative payment model (APM) incentive at 1.88 percent and freezes thresholds to qualify for the incentive. The package also includes a 1.68 percent increase to #Medicare physician payment. NAACOS Statement on Extension of Value-Based Care Incentives  (Attributed to Clif Gaus, Sc.D., President and CEO of the National Association of ACOs):   "NAACOS thanks Congress for including an extension of the advanced alternative payment model (APM) incentive at 1.88 percent in the Consolidated Appropriates Act of 2024. This incentive is critical to supporting clinicians who are accountable for improving quality and lowering costs for patients. We also appreciate that Congress included a 1.68 percent increase in physician payment. These two provisions recognize that we need to ensure that clinicians are paid adequately and have strong incentives to participate in value-based care.     Clinicians in value-based care change delivery, improve care coordination, and offer patients additional services not covered by Medicare. Participation in value-based care is not where Congress intended when these incentives were created nearly a decade ago. We look forward to working with Congress to craft a long-term solution to physician payment that creates sustainability and rewards value." https://lnkd.in/g-8KffpW #valuebasedcare #healthcarepayment

In case you missed it, Congress over the weekend released details on its latest funding package. It includes several so-called "health extenders," among them were policies related to physician payment. But let's look at these numbers more closely. The package would grant a 1.88% bonus for qualifying participation in an Advanced Alternative Payment Model in 2024. This is estimated to equate to roughly $730 million. The package would also grant a 1.68% increase in the Physician Fee Schedule's conversion factor update. That too would equate to roughly $730 million. Stated differently, Congress is giving the same amount of money for value-based care incentives as it is to straight fee-for-service payments in 2024, despite the outsized attention and lobbying the latter received. That speaks volumes about how much policymakers prioritize value-based care and the need to shift our payment system to one that encourages better outcomes at lower costs.

The debate between a free-market healthcare system and a socialised Medicare system is complex and influenced by various economic, psychological, and security traditions. In a free-market system, competition drives innovation, leading to better services and products. Patients have the freedom to choose their healthcare providers, resulting in better health outcomes. Free-market systems are more efficient in resource allocation, leading to shorter wait times and more prompt medical attention. However, the combining of public and private practices can negatively impact care, patient survival, and satisfaction. Socialised Medicare systems have significant costs, including inefficiencies and rationed care. They also lead to an increase in iatrogenic death rates due to high patient-to-doctor ratios and overstretched healthcare infrastructure. The lack of competitive pressure can stifle innovation, leading to complacency and reduced incentive for medical advancements. The most profound cost of socialised medicine is the human cost, as it results in delays in treatment, lack of customised care, and potential medical errors. While a free-market healthcare system offers numerous advantages, the costs of socialized medicine, particularly in terms of human lives and the rise in iatrogenic deaths, present a compelling case for adopting a more market-oriented approach to healthcare. #economics #healthcare #freemarket #Socialisedcare #medicare #psychology #security# #Behaviour #freedom #safety #iatrogenicdeaths #competitiion #innovation #bureaucratichealthcare #accountability #rationedcare #humanlives #medicalerrors #Covid

Curious about how the proposed coding and payment changes in the CY 2024 Medicare Physician Fee Schedule Proposed Rule could impact efforts to align health and social care? (I definitely am.) Join the Partnership to Align Social Care for an upcoming webinar, What Does the CY 2024 Medicare Physician Fee Schedule Proposed Rule Mean for Addressing HRSNs?, on Tuesday, August 22 from 1:30pm ET to 3pm ET. Attendees will hear an overview and discussion of these updates and opportunities to inform the public comment process. CBO and community care hub, health plan, health system, and provider stakeholders who want to learn more about what the proposed coding and payment changes could mean for addressing HRSNs are encouraged to join. Register for the August 22nd event here: https://bit.ly/3E3Y6Ys

This is nuts. How much are we really saving from PA for this burden to be placed on health care professionals?! - 35% spend 35 minutes or more on a single PA request, while it takes up to 91 minutes for 5% of the surveyed practices.  - 30% of practices have to interact with 11 or more health plan portals to acquire PA and 5% interface with five or more portals.  - It takes the involvement of at least three different employees to complete a single PA at 68% of practices. - 77% have hired additional staff or redistributed duties as a result of increased PA requests.  - 97% of the groups reported patients were faced with delays or denials of medically necessary care due to PA requirements. https://lnkd.in/eedhJGkf

Is there a difference between those who opt for Medicare Advantage vs. traditional Medicare Fee-for-Service? A recent study by Inovalon and Harvard Medical School explores the demographic and socioeconomic differences between individuals who select traditional Medicare coverage versus Medicare Advantage. It's a must-read for anyone passionate about transforming senior healthcare equity and outcomes: http://ow.ly/tsu0104Nc7V #healthcarepolicy #Medicare

Few patient portal messages are billed to Medicare Billing for patient portal visits as e-visits under traditional Medicare accounts for a small portion of evaluation and management services, as fewer than 1% of such visits with beneficiaries were billed to Medicare, according to a study in Health Affairs Scholar. Clinicians spent 21 minutes or more on care decisions for 30% of billed e-visits, and half of the billed visits were for primary care. https://lnkd.in/ewFnZUZ3

Three key points in the MACRA proposed rule that providers should be aware of are that physician payment under Medicare is set to change.