Delaware County Medicine & Health Winter 2017 - 6
FEATURE
Survival of Physicians
in a Value-Based World
By Dennis Olmstead, MPA, Pennsylvania Medical Society
W
e're past the tipping point as we proceed
headlong into new market-driven
accountability for quality, cost, and value.
As employers and payers demand proven,
value-based health care, and the market shifts from rewarding
volume to rewarding value, physicians must be able to
demonstrate the highest standard of care to effectively
remain competitive for the foreseeable future. It's not
something we should do - it's something we must do.
Information from the Centers for Medicare and
Medicaid Services (CMS), the Commonwealth of
Pennsylvania, and commercial payers indicates this
value shift will account for a significant portion of
physician reimbursement within just a few short years.
As payment models quickly change, employers and payers
are demanding greater accountability. Physicians are in a
unique position to work together to co-create meaningful
solutions that result in the highest quality of patient care
available and the appropriate rewards for its delivery.
As a result, many physicians are joining together to
seek opportunities for higher levels of success amid these
changes. By participating in an aggregated, larger network
while maintaining practice autonomy, physicians are given
every opportunity to succeed in the new value-based world.
To lead this effort and help Pennsylvania physicians
survive and thrive in this new health care landscape, the
Pennsylvania Medical Society's 2016 House of Delegates
(HOD) passed a landmark initiative on Oct. 23, 2016. This
historic initiative - called the Practice Options Initiative
4
DELAWARE COUNTY MEDICINE & HEALTH
winter 2017
― will create clinically integrated networks (CINs) as well
as a Management Services Organization (MSO) to help
Pennsylvania physicians succeed in value-based care, while
maintaining leadership roles and clinical autonomy.
The MSO will initially provide services within the general
categories of revenue cycle, practice operations, and finance
and business operations. It will include services such as
front end management as well as back end management of
the practice, staff payroll, reimbursement, charge capture,
appeals, coding, practice management, etc., as well as
Medicare Access and CHIP Reauthorization Act of 2015
(MACRA) readiness and Merit-Based Incentive Payment
System (MIPS) reporting. These services will be available
to any physician practicing in Pennsylvania or elsewhere.
One way physicians can succeed in value-based care is
through CINs. A CIN is a group of separate practices
- each with a unique Tax Identification Number (TIN)
- collaborating to demonstrate value, meet quality
metrics, and improve patient outcomes. This is a direct
response to the evolving health care delivery system,
which is moving rapidly toward value-based care led by
passage of MACRA and its accompanying regulations.
This guidance outlines the use of MIPS reporting and
development of Alternative Payment Models (APMs).
A well-led CIN provides the infrastructure to efficiently,
effectively, and comprehensively address the known issues
in health care for the foreseeable future, and an established
physician-led, physician-owned network to efficiently
address the unknown health care shifts of tomorrow.
Table of Contents for the Digital Edition of Delaware County Medicine & Health Winter 2017
Delaware County Medicine & Health Winter 2017 - 1
Delaware County Medicine & Health Winter 2017 - 2
Delaware County Medicine & Health Winter 2017 - 3
Delaware County Medicine & Health Winter 2017 - 4
Delaware County Medicine & Health Winter 2017 - 5
Delaware County Medicine & Health Winter 2017 - 6
Delaware County Medicine & Health Winter 2017 - 7
Delaware County Medicine & Health Winter 2017 - 8
Delaware County Medicine & Health Winter 2017 - 9
Delaware County Medicine & Health Winter 2017 - 10
Delaware County Medicine & Health Winter 2017 - 11
Delaware County Medicine & Health Winter 2017 - 12
Delaware County Medicine & Health Winter 2017 - 13
Delaware County Medicine & Health Winter 2017 - 14
Delaware County Medicine & Health Winter 2017 - 15
Delaware County Medicine & Health Winter 2017 - 16
Delaware County Medicine & Health Winter 2017 - 17
Delaware County Medicine & Health Winter 2017 - 18
Delaware County Medicine & Health Winter 2017 - 19
Delaware County Medicine & Health Winter 2017 - 20
Delaware County Medicine & Health Winter 2017 - 21
Delaware County Medicine & Health Winter 2017 - 22
Delaware County Medicine & Health Winter 2017 - 23
Delaware County Medicine & Health Winter 2017 - 24
https://www.nxtbook.com/hoffmann/delcomed/DelawareMedicalSocietySummerFall2020
https://www.nxtbook.com/hoffmann/delcomed/DelawareMedicalSocietySpring2020
https://www.nxtbook.com/hoffmann/delcomed/DelawareMedicalSocietyFall2019
https://www.nxtbook.com/hoffmann/delcomed/LivingwithLossfromAddiction
https://www.nxtbook.com/hoffmann/delcomed/DelcoMedicalSocietySummer2019
https://www.nxtbook.com/hoffmann/delcomed/DelawareCountyMedicalSocietySpring2019
https://www.nxtbook.com/hoffmann/delcomed/DelawareCountyMedicalSocietyWinter2019
https://www.nxtbook.com/hoffmann/delcomed/DelawareCountyMedicalSocietyFall2018
https://www.nxtbook.com/hoffmann/delcomed/DelawareCountyMedicalSocietySummer2018
https://www.nxtbook.com/hoffmann/delcomed/DelcoMedicalSocietySpring2018
https://www.nxtbook.com/hoffmann/delcomed/DelcoMedicalSociety
https://www.nxtbook.com/hoffmann/delcomed/DelawareCountyMedicalSocietyWinter2017
https://www.nxtbook.com/hoffmann/delcomed/DelawareCountyMedicalSocietyFall2017
https://www.nxtbook.com/hoffmann/delcomed/DelawareCountyMedicalSocietySpring2017A
https://www.nxtbook.com/hoffmann/delcomed/DelawareCountyMedicalSociety
https://www.nxtbookmedia.com