Allies During Uncertainty
Jan 12 2017 - Russell Kohl, MD, FAAFP
It’s been said that the only constant is change. As I and many of my colleagues survey the past year and plan for what is to come in 2017, there isn’t a lot of solid ground to grasp. The continued transition of the payment system from volume to value via the Medicare Access & CHIP Reauthorization ACT of 2015 (MACRA)/Merit-Based Incentive Payment System/Quality Payment Program final rule and implementation has given us plenty to read for the past quarter and over the winter holiday, but a new administration leaves us wondering about the future. Will MACRA really be implemented? What will happen to the Center for Medicare & Medicaid Innovation and the Agency for Healthcare Research and Quality? Will value-based payment return us to the days of restrictive Health Maintenance Organizations? Could this transition reduce physician income at a time when expenses aren’t dropping? The answer to all of these questions is that only time will tell. The challenge becomes how we respond and prepare for a future that remains somewhat nebulous—if not in its ideas, then at least in its implementation. During times like these, it’s important to recommit to your ideals, fortify your foundations and identify allies.
I’m an unabashed Family Physician, but I believe that all physicians are committed to the well-being of their patients and providing them with the best care. What challenges us during this time of transition is the uncertainty of what will be defined as “the best care.” The Centers for Medicare & Medicaid Services has selected a core panel of National Quality Forum measures that are being broadly adopted across many payers in an attempt to provide minimal simplification of administrative tasks. These measures can serve as a starting point for your quality improvement and measurement efforts, but they had better not be the end of them. Strive to identify what is truly important to and for your patients, figure out how to measure those things and focus on improving them. Establishing the basic processes to measure and improve processes and outcomes within your practice will be critical, regardless of future external pressures. Remember, however, that not everything that can be measured is important, and not everything important can be measured.
As the number of groups aiming to aid in practice improvement has grown, many of us face a myriad of requests and offers, with each wanting just a few minutes of your time. The Medicare Quality Improvement Network Quality Improvement Organizations (QIN-QIOs) can be an ally throughout this transition and can help you navigate the maze of projects and provide both the standardized and customized support you need to improve care. With projects ranging from home care to ambulatory offices to nursing homes to skilled nursing facilities to hospitals, QIN-QIOs are structured to realize that our patients move across a continuum of care and that coordinating and integrating what happens in each of those locations is critical to their well-being. Project topics are extensive and varied—from behavioral health integration and diabetes self-management to surgical site and catheter-associated infection prevention, whatever your area of emphasis, you will find allies and resources to help you achieve your goals.
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