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David White

Quality and value care reimbursement: Where is it going in the next couple of years? There has been a great deal of talk and action to move health care from volume-based to value-based reimbursement. Most notable has been the creation of the Quality Payment Program (QPP) to implement the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) and replace the Sustainable Growth Rate (SGR). The program began this year with Medicare designating 2017 as a transition year with Merit-based Incentive Payment System (MIPS) clinicians getting to “pick your pace.” For 2017, the first year, clinicians are only required to

David White

After two years of diligent efforts by the American Society of Nephrology (ASN) and other members of the Alliance for Home Dialysis, the provisions of the CHRONIC Care Act were signed into law after being included in the two-year budget agreement passed in February.  The CHRONIC provisions authorize, among other items, a home dialysis patient’s monthly clinical visits to be conducted via telehealth with the home as an originating site.  ASN and others supported the inclusion of telemedicine provisions in the recent congressional budget deal to pave the way for greater use of the technology and to boost access to care while reducing costs.

While the legislative success was widely applauded by ASN and other members of the Kidney Community, that was just part of the story.  The other part has been playing out on the regulatory side in a choreographed dance between ASN and peer societies on one side and with the Centers for Medicare and Medicaid Services (CMS) on the other.  Perhaps more accurately, the band was warming up and the participants were making their introductions before CHRONIC became law, but now the ball is in full swing.

David White

The American Society of Nephrology (ASN) has joined the world's leading organizations representing clinicians, laboratory researchers, and physician-scientists committed to improving patient care, in support the March for Science and its nonpartisan call for the 
appreciation of scientific evidence, education, and investment. The March is being held today, Saturday, April 22nd, in Washington, D.C. and 604 other cities around the globe.

David White

New opportunities to join Advanced Alternative Payment Models (APMs)

Why Join an Advanced APM?

First, you need to evaluate your practice to determine your best fit under the new Quality Payment Program (QPP):

Alternative Payment Models (APMs) – especially Advanced APMs or

Merit-based Incentive Payment Program

David White

Some good news out of Washington:  Major gains for kidney patients and nephrologists were proposed Thursday, October 27, by the Senate Finance Committee (SFC). 

The Committee’s bipartisan Chronic Care Working Group released draft legislation to improve outcomes for Medicare patients living with chronic conditions – including kidney disease. Numerous provisions ASN advocated for are included in the draft bill, such as allowing patients using home dialysis to interact with their nephrologist via telemedicine from home, and permitting ESRD patients the option to enroll in Medicare Advantage plans (which is not presently allowed). 

David White

American Society of Nephrology (ASN) President Eleanor D. Lederer, MD, FASN, wrote to Senate Majority Leader Mitch McConnell (R-KY) and Minority Leader Charles E. Schumer (D-NY) today expressing ASN’s strong objections to the Graham-Cassidy health care proposal under consideration in the US Senate this week. 

David White

In January, the Government Accountability Office (GAO) released a new report detailing that 17% of Americans (40 million) have kidney diseases and about 680,000 have kidney failure.  Overall, an increasing number of adults who will age into the Medicare program over the next two decades live with multiple chronic conditions – more than two-thirds of beneficiaries in the program today have multiple chronic conditions. Chronically ill patients account for a large percentage of overall Medicare spending – the GAO data shows that Medicare spends nearly $33 billion on kidney failure alone – and will continue to grow creating a demand for programs that provide consistent, high-quality, and coordinated care for these individuals. 

David White

The Centers for Medicare & Medicaid Services (CMS) is conducting its 2018 Burdens Associated with Reporting Quality Measures Study, as outlined in the Quality Payment Program (QPP) Year 2 final rule – 2018 is the QPP’s second year of implementation.  Last year, 2017, was a transition year for the new program.  As the QPP matures and the reporting requirements increase, it is important that nephrologists participate in this study to ensure their reporting burdens are registered.  The American Society of Nephrology (ASN) Quality Committee and ASN Policy staff depend on your participation to advance regulatory policies that are beneficial and, when possible, less burdensome to nephrologists.

David White

If you have been waiting for the final rule from Medicare on MACRA (the Medicare Access and CHIP Reauthorization Act) before taking any steps, your wait is over. The new physician payment system is out: Medicare is calling it the Quality Payment Program (QPP).  Think of it this way: MACRA was the law and the Quality Payment Program is the new program the law created. 

David White

The Centers for Medicare & Medicaid Services (CMS) released the Quality Payment Program (QPP) proposed rule for 2018 on Tuesday, June 20.  While we are only beginning to go through the proposed rule, all 1,058 pages, it does appear that CMS is concerned about the burden of participating in the program on small practices leading to a significant proposed rise in the low-volume threshold.