Institute of Medicine to Address Medicare Payment

The Institute of Medicine (IOM) has several recommendations for Congress and the U.S. Department of Health and Human Services regarding how to improve Medicare’s geographic adjustments in provider payments. One such key recommendation is related to the physician Graphic Price Cost Index (GPCI). Specifically, IOM states that “the GPCIs should use the full range of occupations employed in physicians’ offices, each a fixed national weight based on the hours of each occupation employed in physicians’ offices nationwide”. By doing so, the GPCIs will more accurately reflect the diverse workforce, including both geographic variation in occupations and differing staffing patterns.

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Contact ABISA, a consultancy specializing in solo and small group practice management. Visit us at ABISALLC.com.

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Physicians call for CAUTION in releasing profile data

The Centers for Medicare and Medicaid Services (CMS) is poised to release Medicare data for use in evaluating physician performance. The claims-based data is to be for use in public physician quality reports and is a requirement under the Patient Protection and Affordable Care Act.

The American Medical Association (AMA) and 81 other societies have asked for physicians to be able to review their data before it is released. They have also asked for the data to be accurate (good luck with that one) and in a standard format for comparison with private insurance data. But who is to say that the private carriers will adopt a standard format?

Misaligned incentives indeed.

Why do I say that? Because in their comments, the societies stated the data standards should be applied specifically to risk adjustment and to data attribution to correct physicians.

The societies’ letter to CMS can be found at www.ama-assn.org/resources/doc/washington/medicare-data-release-sign-on-08aug2011.pdf

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Contact ABISA, a consultancy specializing in solo and small group practice management. Visit us at ABISALLC.com.

Physicians at Risk for Massive Cuts

When President Obama signed the debt-ceiling bill, the law automatically set into motion $1.2 trillion in cuts to government programs by December 23, 2011. The deal could produce a 2 percent reduction in Medicare reimbursement. Moreover, the deal makes no mention of fixing the sustainable growth rate (SGR) formula . . . and this formula still currently calls for a 29 percent Medicare reimbursement cut on January 1, 2012.

Of course the AMA continues to be “hopeful” that the SGR issue will be addressed. Indeed the annual scare tactic continues as physicians pray to be able to dodge that bullet once again.

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Contact ABISA, a consultancy specializing in solo and small group practice management. Visit us at ABISALLC.com.

IOM recommends dumping 510(k) process

The Institute of Medicine (IOM) recommended that the Food and Drug Administration (FDA) dump the 510(k) process claiming the process is too flawed. The IOM stated the “FDA’s finite resources would be better invested in developing an integrated pre-market and post-market regulatory framework that provides a reasonable assurance of safety and effectiveness throughout the device life cycle.
Of course, the FDA does not agree. In addition, neither does the Advanced Medical Technology Association nor the Medical Imaging and Technology Alliance.

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Contact ABISA, a consultancy specializing in solo and small group practice management. Visit us at ABISALLC.com.

Meaningful Use Defined

The American Recovery and Reinvestment Act of 2009 has, through CMS, required implementation of Electronic Health Records. CMS has defined key components of meaningful use and detailed the incentive program at www.cms.gov/EHRIncentivePrograms/

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Contact ABISA, a consultancy specializing in solo and small group practice management. Visit us at ABISALLC.com.

ABISA, LLC

ABISA is passionate about the business of oncology care and offers a broad range of services suited to the needs of our clients.  Whether you are concerned about the impact of shrinking reimbursement on patient care, need to formulate strategic direction, or forecast financial viability, ABISA is dedicated to real-world solutions for your success.

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Contact ABISA, a consultancy specializing in solo and small group practice management. Visit us at ABISALLC.com.