A Team-based Practice

"Practice Advancement Strategies played a major role in getting everyone in our practice to understand the concept of team-based practice. They are knowledgeable, organized, focused, and kept us on a timeline that was key to our success. They helped us understand the intricacies and goals of team-based primary care and worked with us to transform the way we interact with our patients.”

  • Value-Based Payment
  • Payment Reform Strategies
  • Approach

Payment Reform Strategies

The Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) established the Quality Payment Program (QPP), a new payment approach that rewards high-quality patient care through participation in Advanced Alternative Payment Models (Advanced APMs) and the Merit-based Incentive Payment System (MIPS).

Evaluating and understanding the impact of value-based payments on physician reimbursement will impact a practice’s successful transition. We support this transition by analyzing the current state, along the various-value based payment spaces and developing an improvement plan.

Provider challenges include:

  • A limited understanding of QPP requirements
  • Aligning multiple groups with disparate electronic health records
  • Motivating providers to understand and embrace change
  • Aggregating data to report accurate, meaningful information
  • Understanding the increased role of cost measures starting in 2018
  • Alignment with health plans and physician offices
  • Identifying resources needed for sustainable success

Our collaborative approach begins with an assessment of the current state of the practice, which includes:

  • Physician Quality Reporting System and Meaningful Use performance
  • Practice operations
  • Clinical quality measure performance
  • Cost of care measure analysis
  • Insurer/managed care analysis, including incentive programs and value-based payment (VBP) arrangements
  • Physician eligibility, education, engagement, and reimbursement models
  • MACRA path: MIPS, MIPS APM, or Advanced APM

Using the results of the assessment, a team is established and a plan and structure are developed to successfully meet and sustain the future state of the provider, practice, or system. Plan development includes:

  • Measure selection
  • Physician education, reimbursement/payment models to transition from fee-for-service to VBP
  • Change management and creating a culture of transparency and continuous quality improvement
  • Establishing structure and processes for data sharing, transparency, and performance dashboard rollouts
  • Improvement activities including Plan-Do-Study-Act cycles, practice transformation, workflow redesign, etc.
  • Leveraging Accountable Care Organization activities for success

We work collaboratively with the practice, group, and/or system to customize an approach that will achieve success under MACRA and value-based reimbursement models.