CY 2016 Medicare Physician Fee Schedule Final Rule Webinar
AAMC and UHC staff hosted a web conference on December 3rd to help faculty practice organizations understand the impact of the CY 2016 Medicare Physician Fee Schedule and to better prepare organizations as Medicare starts implementing the pay-for-performance programs. A PDF version of the presentation is available below. For questions related to the physician payment provisions, please contact Dave Troland. For questions about quality related provisions, please contact Jake Langley or Kathy Yue.
In October, the FPSC Revenue Cycle Suite reports were updated with 2015 benchmarks. Benchmarks are available on a variety of measures, including net collection rates, timeliness of collections, denial rates, and denial resolutions. The 2015 benchmarks are generated using invoices created in calendar year 2014 and activity on those invoices through the first six months of calendar year 2015.
The 2014 QRUR reports were released by CMS on September 9, 2015. The reports can be accessed on the CMS Enterprise Portal at https://portal.cms.gov using an Enterprise Identify Management (EIDM) account with the correct role. See the How to Obtain a QRUR Page for instructions on how to set up an EIDM account and access your TIN’s QRUR. Information about the QRURs is available on the 2014 QRUR website. In addition, CMS has prepared a Fact Sheet providing additional details on 2016 Physician Quality Reporting System (PQRS) payment adjustments. For questions, please contact Jake Langley or Kathy Yue.
New FPSC Physical Medicine Subspecialties
The FPSC team has collaborated with clinical and administrative leaders of the academic physiatry community on the development of sub-specialty benchmarks for the Physical Medicine and Rehabilitation specialty and will be publishing new benchmarks this year:
Physical Medicine: Neurological
Physical Medicine: Pain and Spine
Physical Medicine: Sports – MSK
Physical Medicine: General
(please note: current Physical Medicine benchmark for calendar year 2014 will remain the same once the new subspecialties are published)
These sub-specialties will ultimately replace the previous Physical Medicine specialty. More details on the new Physical Medicine sub-specialty benchmarks as well as the previously published Physical Medicine: Pediatric Rehabilitation benchmark is available via the link below.
Beginning this summer, members of the FPSC Production Team will be sending a list of your existing Physical Medicine providers to your organization’s project and data liaisons asking to remap these providers to one of the aforementioned sub-specialties.
The International Classification of Diseases, Tenth Revision (ICD-10) code set will be adopted on October 1, 2015. In preparation for this transition, the FPSC team has updated the same tables and fields currently used by organizations in their billing data feeds to accommodate either ICD-9 or ICD-10 codes.
During testing, the FPSC found that there were a small number of codes “overlap” codes (i.e. used in ICD-9 and ICD-10 with possible different diagnosis assignments) that relate to obscure cases such as “fall from a railway train” or “lifestyle issues.” Our system will be checking the service date and for any codes where there is duplication between ICD-9 and ICD-10, and if the service was performed before October 1, 2015 it will be assigned the description for the ICD-9 code. If the service was performed on or after October 1, 2015, it will be assigned the description for the ICD-10 code.
For any questions related to the impact of the ICD-10 transition to members, please contact Jennifer Jenkins.
FPSC Annual Conference 2015
+ INFLUENCE: REVOLUTIONIZING PERFORMANCE
Thanks to all who attended this year's FPSC Annual Conference at the Hyatt Regency Chicago. Nearly 250 attendees from around the country gathered to hear from national health care leaders and fellow members on strategies to optimize clinical and operational performance across the continuum of care. This year’s Annual Conference featured an exciting agenda packed with three fantastic keynotes, focus track sessions on practice, revenue cycle, and quality and efficiency management, as well as ample professional and pre-conference social networking activities. To access meeting materials, please click on the materials link below. For questions, please contact Bob Browne or Will Dardani.
We look forward to seeing you next year at the 2016 FPSC Annual Conference! More information on the 2016 Conference will be available later this year.
The 2014 FPSC Work and Total Relative Value Unit (RVU) benchmarks were released this March. All member reports have been refreshed with the 2014 benchmarks. All clinical benchmarks were updated including New Patient Visits; the Revenue benchmarks listed were updated earlier in the year.
Please note - the 2014 benchmark values will carry forward for comparison to your 2015 data until the next set of benchmarks are released in late 2015/early 2016.
The FPSC would like to highlight several enhancements to the benchmarks and online tools with the release of the 2014 FPSC benchmarks:
Fifty-three organizations participated in the CFTE collection process for the 2014 RVU benchmarks.
The minimum provider threshold necessary for a Ambulatory Gynecology benchmark was not met this year and was dropped from the list of specialties with benchmarks.
Eleven new specialties were added this year. The specialties include: Gynecology; Nephrology without Dialysis; Orthopedic Surgery: Shoulder / Elbow; Pediatrics: Cardiology Interventional; Pediatrics: Cardiology-Invasive; Pediatrics: Dermatology; Pediatrics: Rehabilitation; Physical Therapy; Podiatry; Surgery: Breast; and Surgery: Oral are specialties that have been added this year. All specialties now have benchmarks available in the FPSC reporting tool.
The FPSC team thanks you for your participation in the 2014 RVU benchmark development process. For questions related to the benchmarks, please contact Dave Troland (312-775-4357).
Innovations to Improve Health Care Coordination
UHC and AAMC are partnering with five academic medical centers across the country on an initiative to improve health care coordination between primary care physicians and specialty physicians. The $7 million project is being funded by the Center for Medicare and Medicaid Innovation (CMMI) to evaluate the impact of implementation of a consultation and referral platform that is integrated into the electronic health record. To learn more, please visit the UHC, AAMC, or CMS websites.
The New Quality & Efficiency Module
Nearly 50 groups have already signed up for the new module, is your group one of them?
The UHC-AAMC Faculty Practice Solutions Center is pleased to offer a new module to help inform and support member initiatives to improve the cost, efficiency and quality of patient care.
Features of the New FPSC Quality & Efficiency Module:
Reports & Comparative Data
Improvement Toolkits & Networking Opportunities
Robust comparative data on specific CMS quality, cost and outcome measures by GPRO reporting type
Automatic enrollment in focused learning collaboratives that provide guidelines ad toolkits to help improve performance
Comparison of quality tiering scores by GPRO reporting type
Member case studies on successful practices
Additional dynamic, detailed reports with comparative data to further help members assess performance
Expanded networking opportunities including Webinars and symposiums
Staff who can help interpret your QRUR report and provide ad hoc custom analyses
Staff who can serve as liaisons to help facilitate questions and share feedback directly from CMS on your behalf
Please note, the only additional data needed to participate in this module can be pulled directly from your CMS Quality and Resource Use Reports.
To learn more about the Quality & Efficiency Module please contact Jake Langley at 312-775-4239.
UHC Bundles of Care Tool
The UHC Bundles of Care (BOC) tool links patient-level data from the UHC Clinical Data Base (CDB) and the Faculty Practice Solutions Center (FPSC) to allow monitoring of patient outcomes and utilization patterns beyond the inpatient setting. Each report offers over 100 bundle-specific metrics to assist with better understanding of variation, readmissions, complications, resource utilization, and length of stay. Designed for high-level, executive viewing, the dynamic dashboard puts all of these metrics in easy-to-understand graphs and charts.
BOC is provided free of charge to organizations that subscribe to both the UHC CDB and the FPSC. For additional background and to view sample reports, click here. For more information, contact Bob Browne.