Understanding MACRA

By | Reimbursements

By Dr. Jerry Reeves and Aaron Hubbard | HealthInsight Nevada

How clinicians perform compared to their peers will determine whether they receive bonuses
or penalties for services they provide Medicare beneficiaries under the Medicare Access and
CHIP Reauthorization Act of 2015 (MACRA). Required performance reporting for these
incentives begins in 2017.
The Centers for Medicare & Medicaid Services (CMS) recently announced how they plan to
implement MACRA, which replaced the embattled Sustainable Growth Rate formula. The new
Quality Payment Program (QPP) means most clinicians in outpatient practices will participate in
the Merit-Based Incentive Payment System (MIPS), which requires reporting the following to
CMS to determine the performance score that drives payment adjustments:

  • Quality (50 percent weighting at first; decreasing to 30 percent)
  • Resource use (10 percent weighting initially; ramping up to 30 percent)
  • Clinical practice improvement activities (15 percent weighting)
  • Advancing care information (formerly meaningful use; 25 percent weighting)

A few clinicians in CMS-approved advanced alternative payment models (APMs) that share
more than nominal upside and downside payment risk, accept bundled payment arrangements
or participate in patient-centered medical homes may qualify for global bonus payments with
less intensive performance reporting requirements. Those in their first year of Medicare Part B
participation, billing Medicare less than $10,000 and seeing less than 100 Medicare patients
need not participate in MIPS.
With this new system, quality and value are more heavily rewarded than the volume of services
delivered, and burdensome duplicative reporting systems, such as the physician quality
reporting system (PQRS), the value modifier (VM) payment system and the Medicare electronic
health record (EHR) meaningful use incentive program, are combined. The number of quality
measures to report is reduced, and quality measures relevant to more specialties are made
available. A 15-minute video with greater detail can be found here: http://goo.gl/szdR5w
As with prior experiences rolling out Medicare, DRGs, Part D Medicare Drug Programs and
other huge federal payment programs, there may be bumps in the road initially. HealthInsight
has been aggressively preparing for the changes and is offering assistance and answers to help
Nevada clinicians survive and thrive during the challenging transition. We hope you will reach
out and join us as we raise the bar for health quality and safety to improve the health and wellbeing
of the Nevadans we serve.

 

Nathan Adelson Hospice Officially Acquires Las Vegas Solari Hospice Care

By | Developments

Las Vegas (Sept. 7, 2016) – Nathan Adelson Hospice, the largest non-profit hospice in Nevada, announced today that its acquisition of Las Vegas Solari Hospice Care has become effective as of today’s date, September 7, 2016. Solari, an end-of-life health care organization in Southern Nevada owned by HealthCare Partners Nevada, LLC, has closed its operations and finalized the transition of its patients to Nathan Adelson Hospice.

This marks the largest hospice acquisition in Nevada and highlights the changes in the industry as more acquisitions take place throughout the nation. As the industry shifts, a growing number of healthcare systems are turning to hospice leaders, like Nathan Adelson Hospice, that convey an innovative and strong delivery system.

“Making this acquisition official is an exciting time for Nathan Adelson Hospice and our community,” said Nathan Adelson Hospice President and CEO Carole Fisher. “As the leader in end-of-life care in Southern Nevada for more than 38 years, Nathan Adelson Hospice continues to forge a path forward resulting in improved access for patients and their loved ones. We respect HealthCare Partners’ deep knowledge and passion for providing high quality patient care, and share a commitment to ensuring a seamless transition for patients, families, employees and volunteers. This acquisition strengthens our position in the post-acute continuum and as the hospice of choice in Southern Nevada.”

Bard Coats MD, Market President of HealthCare Partners Nevada, LLC, said, “Throughout the years HealthCare Partners and Nathan Adelson Hospice have worked closely together. Our mutual respect and confidence in one another allows for a seamless transition in the quality of care for our patients and families.”

Fisher says that Nathan Adelson Hospice will retain its long-established community identity and will continue to explore strategic relationships and partnerships that ensure sustainability.

About Nathan Adelson Hospice

Nathan Adelson Hospice, the trusted partner in hospice care and palliative medicine for 38 years, is the largest non-profit hospice in Southern Nevada, caring for an average of 400 hospice and palliative care patients daily. In 1978, Nathan Adelson Hospice began providing home care hospice service in Southern Nevada with the mission to offer patients and their loved ones with comprehensive end-of-life care and influence better care for all in the community. In 1983, Nathan Adelson Hospice opened an in-patient hospice in Las Vegas, and today the hospice is recognized as a national model for superior hospice care. The mission of the hospice is to be the Hospice of Choice, the Employer of Preference and a Training Center of Excellence for comprehensive end of life care. Its vision is simple: no one should end the journey of life alone, afraid or in pain.

The hospice also is home to The Center for Compassionate Care, a non-profit counseling agency providing individual, group and family counseling services to address grief, loss and issues related to surviving life-threatening illnesses. For more information, visit www.nah.org.

Las Vegas HEALS Releases Exclusive Malpractice Plans for Members

By | Uncategorized

LAS VEGAS – Las Vegas HEALS (Health, Education, Advocacy and Leadership of Southern Nevada) announced today an exclusive offering of a medical professional liability insurance program to its members.  The Malpractice Savings Package (MSP), designed to offer a savings of up to 30 percent or more on insurance premiums, is the only one of its kind in the Southern Nevada market.

“Malpractice insurance can be the second highest operational expense for a provider.  By adding this offering to our membership, we can provide them with a substantial savings to their operations,” said Doug Geinzer, Chief Executive Officer of Las Vegas HEALS.  “This will also help our physicians in providing high, quality care by allowing them to focus more on their patients.”

Physicians and other licensed healthcare professionals are protected through malpractice insurance from liability associated with the wrongful practices that may have resulted in bodily injury, medical expenses, and property damages in addition to the costs of defending these lawsuits related to claims.  The multi-carrier program exclusively provided to members of Las Vegas HEALS is designed to shop the best rate and coverage to a provider, often times generating a 30 percent or greater savings on insurance premiums.

“Because our community struggles in the level of reimbursement for providers, any expense that can be lowered to help their overall operations allows providers to be able to reinvest in their workforce and the community,” said Geinzer.  “The Malpractice Savings Program is exclusive to our members and we believe it will be a significant benefit for the majority of them.”

Las Vegas HEALS is partnering with Pinnacle Brokers to offer this savings to its members because of Pinnacle’s excellent strength and reputation in the medical malpractice markets in the Nevada and California physician market.  It is one of many benefits that are offered to its members and the savings far exceeds the cost of a Las Vegas HEALS membership.  Members can contact Las Vegas HEALS today to evaluate the anticipated savings for their practice by calling 702-952-2477 or by going to www.lasvegasheals.org/msp.

This new program continues to show Las Vegas HEALS as the leader in driving the healthcare sector in Southern Nevada.  Las Vegas HEALS has found great success in delivering outcomes for the industry since its inception including workforce development by addressing the nursing shortage and the development of the Healthcare 20/20 Program, led the strategic plan for health and wellness travel to expand medical tourism efforts, pushed for statewide Medicaid expansion, and started the conversation that led to $10 million in Graduate Medical Education funding to help expand residencies in Southern Nevada.  It is currently working to address the reimbursement rates in Nevada to help providers to be adequately reimbursed for the services they provide and keep them practicing in the state.

About Las Vegas HEALS

Founded in 2002, Las Vegas HEALS (Health, Education, Advocacy, and Leadership in Southern Nevada) is a nonprofit, membership-based association whose mission is to foster strategic alliances in the healthcare and wellness communities, collaborating on workforce issues, and being a proactive force for legislative initiatives to improve access and enhance the delivery of high quality healthcare.  The organization now represents members who collectively employ over 28,000 health care professionals.  Recent initiatives have included the release of the Las Vegas Regional Strategic Plan for Medical & Wellness Tourism, the expansion of graduate medical education, and the issue of reimbursement rates.

UNLV’S HARRAH HOTEL COLLEGE ANNOUNCES 2ND ANNUAL HOSPITALITY IN HEALTHCARE CONFERENCE

By | Hospitality in Healthcare
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Healthcare Providers Join Hospitality Experts to Explore the Implications of Patient Satisfaction in the Race for Reimbursement

LAS VEGAS – UNLV’s William F. Harrah College of Hotel Administration, in conjunction with the Las Vegas Convention and Visitors Authority and Las Vegas HEALS (Health, Education, Advocacy and Leadership of Southern Nevada), is pleased to announce the 2nd Annual Hospitality in Healthcare Conference on Monday, November 14th, 2016, at the Stan Fulton Building on the UNLV Campus. The conference, hosted by the college’s Professional and Leadership (PLuS) Center, will bring high performing healthcare firms and executives from the hospitality industry together to share best practices for improving patient satisfaction and healthcare outcomes.

As the patient experience continues to play a more critical role in how health care providers are reimbursed by insurance companies, creating a distinctive patient experience is quickly becoming the new gold standard. The conference, as part of The PLuS Center’s How Vegas Does Vegas™ education series, will give healthcare providers behind-the-scenes insights into how excellent service delivery promotes patient satisfaction. Some of the hospitality industry’s most successful leaders will be on hand to present real case studies that can be applied to any healthcare organization.

This program, designed specifically for healthcare professionals, will be led by Dr. Stowe Shoemaker, Harrah Hotel College dean and expert in loyalty and customer satisfaction practices, as well as Doug Geinzer, CEO of Las Vegas HEALS. Speakers include Dr. Joseph Steele from MD Anderson Cancer Center, Sharon Messimer of Texas Health Resources, Peter Yesawich from Cancer Treatment Centers of America, Eileen Moore Regional President Caesars Entertainment . Central to the discussion will be Shoemaker’s “Loyalty Circle,” which is being successfully applied in healthcare organizations, such as MD Anderson, and in numerous well-known hospitality and gaming properties throughout the world.

The keynote presentation will be delivered by Leah Binder, president and CEO of The Leapfrog Group, the nation’s nonprofit purchaser-driven enterprise to drive a transparent market for high-value hospital care. Binder will summarize purchaser strategies at the national level that include the alignment of benefit programs with CMS’ value programs, while working with plans and others to tie payment to excellence.

To learn more about this event or to register to be a part of this important discussion, please visit www.lasvegasheals.org or call the UNLV PLuS Center at (702) 895-4430.

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Healthcare Marketing in the Digital Space: A Prescription for Success

By | Medical Marketing

By Casey Floyd

Vice President of Integrated Marketing

MassMedia Health

Digital advertising by U.S. healthcare firms will approach $2 billion in 2016, a 15.4 percent increase over last year, according to a presentation developed by Patricia Orsini, market analyst at eMarketer. This trend shows no signs of slowing; mobile and social advertising spend is expected to show double digit percentage increases for at least the rest of the decade. Today’s healthcare organizations must supercharge their online presence or risk being left behind.

The reasons for this exponential growth in digital healthcare advertising is clear. As tablets, web-enabled cell phones and laptop computers become ubiquitous among physicians, hospital administrators, payers and patients, organizations must project themselves where they can be seen, evaluated and present themselves as industry leaders and experts.

The tactics that will be effective in accomplishing these goals, however, are as unique as the firms using them. Corporate values, competitors, the nature of the industry and geography in which they compete, their go-to-market strategies and a host of other variables bear on how healthcare industry participants can best employ the power of online marketing.

Ironically, though healthcare is among leaders when it comes to embracing technological advances for treating patients it is often slow to adopt tech to communicate, manage and grow their markets.

Your competition likely fails to leverage the available digital resources to attract prospects, engage, inform and convert them to patients, shape their opinions and turn them into evangelists. If so, the door is open for you to claim additional market share. The key is to partner with an agency that thoroughly understands the digital advertising and content space, one that possesses both the insight to identify and the resources to implement the strategies, messages and dissemination methods that will attract and resonate the people who need the services you provide.

Clinics, healthcare partnerships, pharmacies, etc. generally take a shotgun approach to marketing. It’s a vestige of traditional marketing, when anad in the city telephone directory and the Sunday newspaper was considered a comprehensive marketing plan. When you ask a healthcare group who its primary target market is, the response typically is “All people nearby,” or “whoever we can get!”

Digital marketing ushers in a new paradigm and calls for radically different execution. While the concept of market segmentation is not new, the digital tools available to healthcare professionals make it possible to tailor specific messages for specific potential clients – based on their demographics, lifestyles, online behavior, interests and beliefs.

We put away the shotgun and take a sniper approach to deliver relevant messages to specific people by building profiles around these patients and then delivering value-added services that are important to them.

A strong digital marketing platform and a knowledgeable partner also position pharmaceutical manufacturers, medical device producers, therapists, hospital and other B2B healthcare businesses to react to changing market trends. For instance, Medical Marketing & Media’s latest Healthcare Marketers Trend Report notes that barely half the healthcare industry participants surveyed ranked patients and insurers among their top three target markets. While physicians and other providers rightfully remain the top target of healthcare firms’ marketing messages, companies that neglect payers and consumers, again, ignore the shifting paradigm.

Today’s treatment options are governed as much by how much of the procedures’ costs will be covered by insurance as by their efficacy and need. A portion of healthcare firms’ digital marketing budget should be allocated to educating payers and advocating for coverage both to generate revenue and to promote optimal patient wellbeing.

At the same time, consumers are taking greater responsibility for their own healthcare decisions. Reputation and brand identity play an increasingly large role in consumer choice. And with ratings sites, social media platforms and instant access to information proliferating, digital channels ultimately will shape user opinions.

However, consumers continue to be inundated with generic brand messages promoting “quality” care from physicians’ groups, empty promises from insurance companies scare tactics from pharmaceutical companies warning of dire consequences for failing to use their drugs.

Digital marketers that provide accurate healthcare information will find a voracious audience (witness the popularity of WebMD and other less accurate sources for self-diagnosis). Establishing trust through proven online and social platforms such as content marketing and blogs can attract readers and convert them to clients.

More often than not, healthcare providers and companies are stuck in an analog marketing world. They continue to throw money at digital marketing ventures with no true understanding of how to accomplish their goals or even what those goals really are. Their mistakes can be your goldmine. The healthcare industry is extremely competitive and it is a zero-sum game. Patients generally use one doctor, one dentist, and one lab. When you out-market them in the digital workspace and cause them to switch, the effect is doubled. Your practice gains a patient, while your competition loses one. This makes it imperative to outperform others in your industry when it comes to marketing. The others will not invest the time and resources to analyze the competition and establish a position that will set their message apart. You will not make that mistake if you hire a digital marketing and public relations agency that will dig into the competition’s weaknesses, accentuate your strengths and develop a tactical ad placement schedule that will magnify the effects of laser-guided messaging, making sure it is delivered at the right place, at the right time.

For instance, when I partner with a healthcare client, I work with them to first determine what online action we want a potential customer to take. It might be something as simple as watching an educational video on the client’s website or subscribing to an email list so we can capture information that will guide our optimization of future engagements. From there, I can “reverse engineer” our methods and tactics, creating messages and contact points that will achieve the client’s objective.

Where your competitors get digital marketing wrong, there is opportunity to jump in and do it right. Generally, healthcare marketing is cold and unauthentic. It does not connect with the consumer. Testimonials tend to do well, because there is some authenticity there. But consumers are wising up to this ploy. Noble as it is, healthcare organizations are businesses. It’s time they started acting like it in the digital marketplace. Non-profits, consumer-oriented, and even B2B and government websites often exhibit a more authentic human approach. Healthcare should take a page from their book by providing curated content for their audience and delivering it in niche locations and niche media. The industry should connect on every level to the consumer and react to feedback. And it should say something different than the same old platitudes the competition spouts and capitalize on the competition’s cluelessness. They should experiment with marketing dollars. A little bit goes a long way in digital marketing, and healthcare organizations can improve their images, attract traffic and ultimately increase revenue with an active, dynamic social media presence. Answering patient questions. Showcase true patient interactions. Put a face to your brand!

For help with your healthcare organization’s digital strategy, please contact by email at Paula@massmediacc.com or by phone at 888.777.5146.

Cleveland Clinic – Healthcare Interior Design Program

By | Education, Hospitality in Healthcare, Innovation

Wednesday, aug. 24, 2016, las vegas – cleveland clinic lou ruvo center for brain health and the university of nevada, las vegas (unlv) have teamed up to offer the first master of healthcare interior design program in north america. The post-professional program, which is part of the school of architecture, provides students with a unique, cross-disciplinary and research-driven educational experience focusing on the design of healthcare environments for those living with neurodegenerative diseases.

As part of the collaboration, specialists in neurology, psychiatry and neuropsychology at cleveland clinic lou ruvo center for brain health (cclrcbh) will provide unlv students with the medical knowledge necessary to understand the considerations and challenges in designing living and working environments for the neurologically impaired and to prepare program graduates for careers in the healthcare interior design profession.

“the new master’s program builds on the monumental success we had with the healthcare design courses in the interior architecture and design undergraduate professional program, which we started four years ago,” said dr. Dylan wint, cclrcbh’s nv energy chair for brain health education. “the center and unlv have a long and thriving history in research collaboration and it’s encouraging to see our program, which benefits the lives of the patients we treat here at the center, continue to grow and make advancements in healthcare and interior design.”

The evidence-based program, which will welcome its first class of students on aug. 29, uses current research and trends in neuroscience to create healthier spaces, which ultimately make those living with brain diseases feel better and perform better in day-to-day activities. Students will take into account things like the acoustic environment, lighting and the use of natural materials to design a space that feels warmer and less industrialized, which tends to have a positive impact on patients.

“this will lead to graduates who are creative and innovative problem-solvers and who can productively function across disciplines creating a better educated workforce for the jobs of the future in the $3 trillion united states healthcare market, the largest healthcare industry in the world,” said professor attila lawrence, who is heading the new program.

For additional information about cleveland clinic lou ruvo center for brain health, visit clevelandclinic.Org/brainhealth. For additional information about unlv, visit unlv.Edu.

About Cleveland Clinic
Cleveland Clinic is a nonprofit multispecialty academic medical center that integrates clinical and hospital care with research and education. Located in Cleveland, Ohio…