Value-Based Payment for Specialists: Models Built on Primary and Pharmacy Care

Value-Based Payment for Specialists: Models Built on Primary and Pharmacy Care

Value-based payment requires the deeper use of electronic health records (EHR) to capture and transmit standardized data. This analysis will include a review of 3 working models that specialists should consider joining to enhance both clinical and financial performance. These models include high-functioning primary care and pharmacy networks in the US and work accomplished by the American Academy of Physical Medicine and Rehabilitation.

MACRA IT Considerations – General Summary

With the final rule on the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) released by CMS in October 2016 and the rule going into effect in CY 2017, healthcare providers are now tasked with the readiness and implementation plan to meet the parameters of the Merit-Based Incentive Payment System (MIPS) and the Advanced Alternative Payment Models (APMs). The Department of Health and Human Services (HHS), in collaboration with partners in the private, public, and non-profit sectors, launched the Healthcare Learning and Action Network (LAN), to assist in advancing the adoption of value-based healthcare and alternative payment models. As part of this effort, the LAN developed an APM framework that categorizes the transition from fee-for-service to population-based quality care.