Listen Now!

Business Talk 24-7

Medicare’s Merit-based Incentive Payment System (MIPS)

MIPS

Elizabeth Woodcock

Medicare’s Merit-based Incentive Payment System (MIPS)

On this week’s episode we continue our series with Medical Association of Georgia, talking about the changing reimbursement picture for physician practices by the Centers for Medicare and Medicaid Services.  Medicare’s new Merit-based Incentive Payment System (MIPS) will change, yet again, physician reimbursement over the next couple of years and it is important for practice managers and physicians to make sure they understand all new requirements.

It is imperative for medical practices to make a successful transition to Medicare’s new Merit-based Incentive Payment System (MIPS). Instead of the EHR (Electronic Health Record) or the PQRS (Physician Quality Reporting System) or the Value-based Payment Modifier programs, the government will employ a single payment platform – which is the result of the Medicare Access and CHIP Reauthorization Act (MACRA) that was signed into law in 2015.

The new payment model will be based on a 100-point MIPS Composite Performance Score. That CPS will determine your Medicare payment adjustment – either up or down. This is scheduled to commence in 2019, and the Centers for Medicare and Medicaid Services will use the 2017 calendar year as the basis for the initial reimbursement – keeping mind this is not an optional process.

Elizabeth Woodcock is one of the leading third party payer and medical practice management consultants in Georgia. She is a professional speaker, trainer and author. Woodcock has focused on medical practice operations for more than 20 years. She has delivered presentations at regional and national conferences to more than 200,000 physicians and managers.

In addition to her popular email newsletters, she has authored 15 best-selling practice management books and published dozens of articles in national health
care management journals. Woodcock is a fellow in the American College of Medical Practice Executives and a certified professional coder. In addition to a degree from Duke University, she has an MBA in health care management from The Wharton School of Business of the University of Pennsylvania.

Special Guest:

Elizabeth Woodcock, Principal, Woodcock & Associates  linkedin_small1

woodcock

Pre-pregnancy and Prenatal Genetic Testing

genetic testing

Tanya Mack of Women’s Telehealth

Pre-pregnancy and Prenatal Genetic Testing

We continue our twice-monthly series with Women’s Telehealth’s Tanya Mack.  She caught up with Certified Genetic Counselor, Rachel Klein, of GenPath Diagnostics.  The topic of discussion was focused on pre-pregnancy and prenatal genetic testing, when it makes sense, the difference between screening and diagnostic tests, how to deal with results, and more.

Women are routinely offered a variety of genetic tests during the first three months of pregnancy in the US.  Every woman wants to believe their baby is normal and uncomplicated. However, the CDC reports that 1:33 babies born in the US will have a birth defect. Genetic tests, both screening and diagnostic, show the likelihood that a developing baby has a genetic condition that may cause problems with growth, development and bodily functions.

Information from genetic testing plus the mother’s age, the couple’s ethnic background and a family history of a genetic disorder can help calculate the odds that the fetus might have a defect such as Cystic Fibrosis, Tay-Sach’s Disease, Sickle Cell Anemia, Down’s Syndrome or neural tube defects. Joining us for this segment of Top Docs is Rachel Klein, a Certified Genetic Counselor from one of the nation’s leading prenatal genetic testing labs, GenPath.

Special Guest:

Rachel Klein, Genetic Counseling Program Manager, GenPath Diagnostics  linkedin_small1  twitter_logo_small-e1403698475314  facebook_logo_small3  

genetic testing

 

Transforming Clinical Practice Initiative (TCPI)

TCPI

Dr. Doug Patten

Transforming Clinical Practice Initiative (TCPI)

Dr. Doug Patten is the chief medical officer of the Georgia Hospital Association, which is the leading advocate for Georgia’s hospitals and health systems. GHA supports the efforts of its members as they strive to improve access to health services, improving the health of all Georgians. Dr. Patten was a general surgeon in southern Georgia before he became the chief medical officer of the Phoebe Health System in Albany.

He has been GHA’s chief medical officer for nearly two years. He is focused on improving quality and safety, engaging patients and their families, and physician leadership. He is a member of the Medical Association of Georgia and the American College of Surgeons.

The Transforming Clinical Practice Initiative (TCPI) is designed to help more than 150,000 U.S clinicians improve quality and reduce costs – keeping in mind that the Medicare is changing from a volume-based payment system to a quality-based payment system in the next several years. The four-year, $800 million TCPI initiative is being funded by the Center for Medicare & Medicaid Innovation.

It is aligned with the Affordable Care Act (ACA) and the Medicare Access and Reauthorization Act of 2015 (MACRA). The TCPI includes a network of 29 “practice transformation networks” (PTNs) that are designed to 1) improve health outcomes and 2) improve care coordination and 3) better engage patients and families and 4) improve patient, clinician and staff satisfaction and 5) reduce the overall cost of care.

There is no cost for clinicians or practices to join a PTN. There are four PTNs that support clinicians in Georgia, including the Compass PTN – which has been endorsed by the Medical Association of Georgia given MAG’s “multi-year collaboration with GHA on matters related to quality, safety and community health.”

The Compass PTN will serve more than 7,000 primary and specialty care clinicians in six states. The Compass PTN is led by six non-profit partners, including the Georgia Hospital Association. In Georgia, the Compass PTN hopes to serve 1,000 clinicians, including 150 specialists.

Special Guest:

Dr. Doug Patten, CMO, Georgia Hospital Association  youtube logo  linkedin_small1  twitter_logo_small-e1403698475314  facebook_logo_small3

TCPI

Zika Virus

Zika

Dr. Cherie Drenzek

zika

Dr. Patrick O’Neal

Zika Virus

The Zika virus has been making news over the past year as we approach the coming Olympics in Brazil, a known location heavily populated by the species of mosquito known to carry the virus.  I sat down with Dr. Patrick O’Neal of the Georgia’s Department of Public Health, and Dr. Cherie Drenzek, Epidemiologist for the State of Georgia to talk about what we need to be thinking about here in Georgia.

Dr. Cherie Drenzek grew up in Detroit and received her bachelor’s degree in Biological Sciences and her Master’s degree in Food Microbiology from Wayne State University. She attended Michigan State University College of Veterinary Medicine and received her DVM in 1995. She then entered the Epidemic Intelligence Service program at CDC and was stationed in the Rabies Section. Following EIS, Dr. Drenzek was employed as an Assistant Professor of Epidemiology at the University of Georgia College of Veterinary Medicine.

Dr. Drenzek has been employed at the Georgia Department of Public Health since 1999 and has served in a variety of roles, including infectious disease medical epidemiologist and State Public Health Veterinarian. She served as Director of the Acute Disease Epidemiology Section and Deputy State Epidemiologist since October 2005 and was named State Epidemiologist and Director of the Epidemiology Program in 2011.

Dr. Patrick O’Neal is the Director of Health Protection for the Georgia Department of Public Health (DPH), where he has oversight responsibility for Emergency Medical Services (EMS), Trauma, Emergency Preparedness, Epidemiology, Infectious Disease, Immunizations, and Environmental Health. For 29 years prior, he practiced
emergency medicine at DeKalb Medical Center in Decatur. He received his medical education at the Tulane University School of Medicine in New Orleans.

Zika virus (pronunciation: zee-kah) is a viral disease that is primarily transmitted to people by infected Aedes species mosquitoes. The most common symptoms of Zika are fever, rash, joint pain, and conjunctivitis. The illness is usually mild with symptoms lasting for several days to a week after being bitten by an infected mosquito.

However, there can be more severe clinical outcomes, and Zika virus infection during pregnancy can cause a serious birth defect called microcephaly, as well as other severe fetal brain defects.  Prior to 2015, outbreaks have occurred in Africa, Southeast Asia, and islands in the Pacific Ocean.  In May 2015, Zika virus transmission was confirmed in Brazil and outbreaks are currently occurring in many countries in the Americas and worldwide.

No local mosquito-borne Zika virus disease cases have been reported in the continental U.S., but there have been travel-associated cases, as well as cases associated with sexual transmission from travelers to affected areas. These imported cases could result in local spread of the virus in areas of the United States where the Aedes mosquito vectors are found. A list of countries where Zika virus is currently being spread can be found at the CDC website http://www.cdc.gov/zika/geo/index.html. Zika is an unprecedented public health emergency that poses significant risks to pregnant women.

This is the first time in more than 50 years that a virus has been linked to serious birth defects and poor pregnancy outcomes (and the first-ever mosquito-borne cause!).  Georgia has not documented any local transmission of Zika virus, but as of the end of April 2016, has confirmed more than a dozen travel-associated Zika infections.

For general information about Zika virus and surveillance for mosquito‐borne diseases in Georgia, call your District or County Health Department or the Georgia Department of Public Health at 404‐657‐2588. You may also visit the Georgia Department of Public Health website at dph.georgia.gov. Also go to the CDC website at cdc.gov/zika/index.html.

Special Guests:

Dr. Cherie Drenzek, Epidemiologist, Georgia Department of Public Health

feed logo  twitter_logo_small-e1403698475314  facebook_logo_small3  youtube logo

Dr. Patrick O’Neal, MD, Director of Health Protection, Georgia Department of Public Health

 

Azalea Health

Azalea Health

Baha Zeidan

Azalea Health

This week we started our twice-monthly series with Tanya Mack, CEO of Women’s Telehealth.  Her first guest was CEO and Co-founder of Azalea Health, Baha Zeidan.  Azalea Health is an EMR company that launched in 2008 in Valdosta, GA.  Since then the company has enjoyed steady growth and has been recognized as one of Inc. 500 Nation’s fastest growing private companies, Georgia Top 40 Innovator, and 2014 Emerging Company of the Year Phoenix Award Winner.

Healthcare IT is at the forefront of revolutionizing trends that will change the way healthcare is delivered and patients’ health and wellness outcomes. Healthcare providers and patients who are resistant to technology may be left behind. Today- EMR’s, patient portals, mobile health apps and wearables, cloud computing, and interoperability are not fringe applications but active advances that allow the patients to become more a part of the healthcare team.

Technology makes that possible. Currently, the global EMR market is $11 Billion and the US remains dominant in EMR adoption. As we move to electronic medical records, EMR’s hold a lifetime of health data and can be used to predict our individual health future through modeling.

Today’s guest, Baha Zeidan, CEO of Azalea Health will be discussing his company’s
EMR and Practice management platform and how it is evolving to incorporate these new technology advances.

Special Guests:

Baha Zeidan, CEO of Azalea Health  linkedin_small1  twitter_logo_small  feed logo  facebook_logo_small3  youtube logo  

Azalea Health

Tanya Mack, President, Women’s Telehealth  youtube logo  linkedin_small1  twitter_logo_small-e1403698475314  facebook_logo_small3

telemedicine