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Quality Performance

The value-based reimbursement model requires performance on several key areas, quality, resource use, clinical practice improvement activities, and use of an EHR.

Why ‘Value-Based’?

Value is important in the health care system. Insurance payers and states are increasingly rewarding practitioners who provide improved patient care and cost savings. The patient-centered medical home (PCMH) model of care – one in which care is centrally coordinated and tracked by one primary care provider – has become the standard by which primary care can achieve better patient care and lower costs.
 
 

Medicare’s New Quality Payment System

MACRA, MIPS, & Chiropractic: Medicare’s New Quality Payment System

This is a 5 part online course defining how Doctors of Chiropractic can participate in the new Quality Payment Program as defined by the Medicare Access and CHIP Reauthorization Act 2015 (MACRA) Law: the Merit-Based Incentive Payment System (MIPS) and the Advanced Alternative Payment Model (APM). The MACRA law outlines the requirements and timeline regarding Medicare payment system changes, with the performance year as identified in the proposed rule beginning January 2017. This course gives an overview of this law and will offer information about performance standards and how to achieve these standards for reimbursements in the future.
 

Quality Payment Program

Best Practices Academy will be sure your practice is ready to migrate from fee-for-service to the new value-based payment system. The MACRA law outlines the requirements and timeline regarding Medicare payment system changes, with the performance year as identified in the proposed rule beginning January 2017. This 10 module on-demand series provides a detail explanation of the new payment system and how the chiropractic physician can implement appropriate activities and work processes that support performance in a value-based payment system.
 
 
 

Practice Recognition Program

Healthcare is changing and your clinic will need to change with it or you may be penalized and ultimately left behind. By 2020 75% of all reimbursements will be tied to your outcomes. In 2019 Merit-based Incentive Payment System will replace the PQRS program. You are required to report going forward as penalties have arrived in 2015. You have an option to choose to become recognized in the PCCC program which is connected to the PCMH model to meet your quality reporting measures. You can reduce revenue threats. BPA can navigate you through this extremely complex process! The Practice Recognition Program guides you through the NCQA Patient Centered Connected CareTM Program.

The value-based reimbursement model requires performance on several key areas, quality, resource use, clinical practice improvement activities, and use of an EHR. Practice recognition programs are standards created by organizations such as the National Committee on Quality Assurance (NCQA), Utilization Review Accreditation Commission (URAC), and Accreditation Association for Ambulatory Health Care (AAAHC). BPA provides training, policy and expert coaching by a NCQA certified content expert for the practice. Achieving recognition status may satisfy clinical practice improvement activities requirements within value-based payment systems.


Objectives:

  • Achieve recognition status with NCQA Patient-Centered Connected Care Standards
  • Evidence based Practice Training
  • Support delivery of patient-centered care by coordinating with and connecting with other primary care providers
  • Continuous Quality Improvement program
  • Clinical Case Conferences
  • Practice Consulting with Content Experts
  • 40 total courses
    • 30 courses in the base program
    • 10 courses during the reporting period (90 Day)
  • Includes CG CAHPS service
  • Does not include recognition application fees for NCQA (Estimated $1500 per location plus survey costs all payable to NCQA)


Additional Client Benefits:

  • Benefit Program (Courses & Business Resources)
  • Client Discount on Seminars
  • eCommerce Store Branding ($99 value)
  • Clinical Grand Rounds (Monthly Group Coaching/Collaboration)
  • Individual & Group Coaching
  • Unlimited Access to Quality Performance Online & On Demand Courses
  • Discounts on Select Online Courses
  • Special Rate on Clinical Decision Support Tool $49/month ($100 savings/month)


Pricing:

Monthly Fee of $499 first provider, $99/provider thereafter for 15 months. The Agreement will automatically renew for successive one (1) year terms unless terminated by either party upon no less than thirty (30) days written notice prior to the termination of the initial or any renewal term.

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Care Coordination Program:

Must have completed Quality Payment Performance Program or Practice Recognition Program first.

The end game for reducing fragmentation in care delivery hinges on successful models for care coordination and collaboration.  BPA clients who have achieved practice recognition in programs such as the PCCC position their practices for meaningful referral relationships with allopathic primary care providers.

BPA makes a best effort to position the practice for referrals and growth by facilitating key relationships through health plan and health system sponsorships, integrated learning activities and sustaining your PCCC recognition (virtual and face to face settings; i.e. seminars, clinical case conferences), and ongoing client quality assurance/improvement activities.

  • Quality Assurance/Improvement Plan Management
    • Individualized Practice Improvement Plan
    • CG CAHPS
    • PQRS & CQMs, MU, KPI follow-up
    • Other
  • Clinical Practice Improvement Activity Training (Doctor and Staff)
    • Care Coordination and Community Resources
    • Care Planning and Co-management
    • Integrated Care Pathways
    • CQM’s Training
  • Clinical Virtual Grand Rounds
  • Includes CG CAHPS service
  • Includes reporting costs
  • Does not include recognition renewal fees for NCQA


Additional Client Benefits:

  • Benefit Program (Courses & Business Resources)
  • Client Discount on Seminars
  • eCommerce Store Branding ($99 value)
  • Clinical Grand Rounds (Monthly Group Coaching/Collaboration)
  • Individual & Group Coaching
  • Unlimited Access to Quality Performance Online & On Demand Courses
  • Discounts on Select Online Courses
  • Special Rate on Clinical Decision Support Tool $49/month ($100 savings/month)


Pricing:

Agreement is 12 months, with a termination option with notification of 30 days prior to renewal

Monthly Fee of $399/month 1st DC, $99/month Additional DCs. The Agreement will automatically renew for successive one (1) year terms unless terminated by either party upon no less than thirty (30) days written notice prior to the termination of the initial or any renewal term.
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