​Overview

In this webinar we address the many efforts that the Medicare program is currently undertaking and/or is in the process of developing.  The latest major efforts involve mandates from MACRA (Medicare Access & CHIP Reauthorization Act) relative to the discontinuation of the SGR (Sustainable Growth Rate) through implementation of programs such as MIPS (Merit-Based Incentive Payment System).  Some of the initiatives from Medicare involve cost-savings through efficiency improvement, while others involve effectiveness improvement through better care.

Webinar Objectives

•  discuss the fundamental challenge between reducing payment and improving quality of healthcare
  
• review the various Medicare payment systems from a quality and value perspective
  
• review twin goals of efficiency (reduced costs) and effectiveness (increase quality)
  
• discuss the main initiatives from Medicare concerning quality, value and associated payment impacts for all types of healthcare providers
  
• review the current Medicare quality programs for hospitals
  
• analyze the proposals from Medicare concerning the implementation of the MACRA-mandated Merit-Based Incentive Program
  
• review current Medicare quality and value-purchasing for other healthcare providers such as HHAs, SNFs, and DME
  
• examine the future of quality and value-based initiatives from Medicare and the anticipated impacts from such initiatives
  
• discuss special approaches being taken by the Medicare program at both an organizational level as well as at a service level
  

Target Audience

Hospital Management, Medical Staff Organization Personnel, Clinical Department Managers, Utilization Review and Case Management Personnel, Clinical Staff, Nursing Staff, Physicians, Non-Physician Practitioners, Physician Practice Managers, Clinic Administrators, Financial Analysts, Revenue Cycle Specialists, Chargemaster Coordinators, Provider-Based Clinic Staff, Compliance Personnel, Other Interested Personnel

Webinar Outline

• Overview of Quality and Value Initiatives from Medicare
  
• Quality Reporting
  
• Value-Based Purchasing
  
• Payment Adjustments for Quality
  
• Patient to Physician Relationship
  
• Congressional Actions
  
• Review Medicare Payment Systems
  
• Fee Schedules
  
• Prospective Payment Systems
  
• Hybrid Payment Systems
  
• Cost-Based Payment Systems
  
• Hospital Quality Programs
  
• Inpatient Quality Reporting (IQR)
  
• Outpatient Quality Reporting (OQR)
  
• Value-Based Purchasing (VBP)
  
• Hospital-Acquired Condition Reduction Program (HAC)
  
• Readmission Reduction Program (RRP)
  
• Electronic Health Record (EHR)
  
• Physician Quality and Value Programs
  
• Sustainable Growth Rate (SGR)
  
• Current Initiatives
  
• PQRS – Physician Quality Reporting System
  
• Value-Based Payment Modifier (VM)
  
• EHR Initiative
  
• Physician Feedback System
  
• Value-Based Payment Modifier
  
• Merit-Based Incentive Payment System (MIPS)
  
• Alternative Payment Models (APM)
  
• Other Healthcare Providers
  
• Value-Based Purchasing for HHAs.
  
• Value-Based Purchasing for SNFs
  
• Quality Reporting for LTCHs
  
• DME Initiatives
  
• Other Healthcare Providers
  
• Trends and the Future
  
• Budget Neutral Implementation
  
• Costs for Reporting and Maintaining Reimbursement
  
• Incentives versus Penalties
  
• Sources for Further Information
  

About the Speaker

Dr. Duane Abbey is a management consultant and president of Abbey & Abbey Consultants, based in Ames, Iowa. For over twenty years Abbey & Abbey, Consultants, Inc. has provided superior healthcare consulting services to hospitals, hospital systems, physicians, medical clinics and integrated delivery systems.

Abbey & Abbey, Consultants, Inc. specializes in healthcare consulting primarily in the areas of:

• Payment systems - reimbursement consulting
  
• Delivery systems - organization of healthcare delivery
  
• Compliance - developing compliance programs - emphasis in the coding, billing and reimbursement areas

In addition to his consulting, Dr. Abbey has been an invited presenter for hospital associations, medical societies, and other groups. He has also published both articles and books on health care topics. Dr. Abbey earned his graduate degrees from the University of Notre Dame and Iowa State University.

Continuing Education Credits

Nursing participants: Instruct-online has approved this program for 1.8 contact hours, Iowa Board of Nursing Approved Provider Number 339.

All other participants: Must attend the entire Webinar and complete a Webinar critique to receive a 1.5 Hour Attendance Certificate for each program.