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April 26, 2018

ACO roundup: Only 37% of MIPS quality measures are valid, ACP says

Daily Briefing
    • ACP: Fewer than 40% of MIPS quality measures are valid. Just under 40% of the 271 quality measures included in the Merit-based Incentive Payment System (MIPS) to assess physician performance are valid, according to an analysis from the American College of Physicians (ACP). For the analysis, ACP assessed MIPS quality measures for validity in five domains, including importance, appropriateness, clinical evidence, specifications, and feasibility and application. Of the measures, ACP said only 37% were valid, while 35% fell short of the validity test and 28% were of uncertain validity. Based on the findings, ACP called for a "time-out" to examine and improve MIPS quality measures, stating, "The use of flawed measures is not only frustrating to physicians but also potentially harmful to patients. Moreover, such activities introduce inefficiencies and administrative costs into a health system widely regarded as too expensive."

    • Walmart, Emory launch an ACO. Walmart and Emory Healthcare have partnered to launch an ACO to serve Walmart employees in the Atlanta metropolitan area. Under the partnership, which took effect Jan. 1, about 10,800 employees at 55 Walmart and Sam's Club locations in the Atlanta metro area can select Emory Accountable Care Plan as their primary health plan. Members have access to more than 2,000 physicians in the Emory Healthcare Network and are charged copayments for primary, specialist, and urgent care. Preventive care services are available at no cost. Members enrolled in the Emory ACO also have access to certain weight-loss and cardiac surgeries at no out-of-pocket costs.

    • AMA, physician groups call for curtailed MIPS reporting period. In a letter to CMS Administrator Seema Verma, the American Medical Association and more than 40 other physician groups are urging the federal government to reduce the 2018 Merit-based Incentive Payment System (MIPS) reporting period from one year to 90 days. The groups in the letter said the reporting period should be abbreviated because CMS did not promptly notify physicians on their MIPS eligibility and because the Quality Payment Program website will not be ready by this summer, which the groups said stems from the agency's "severe delay."

    From Advisory Board:

    • Transform your business model for Medicaid risk. Join us on Tuesday, May 15 at 1:00 p.m. ET, to learn how, with the increased financial flexibility of Medicaid risk, health systems can adapt their existing care management infrastructure to better manage the Medicaid population.

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    • Everything you need to know about the proposed IPPS rule. Join us on Tuesday, May 22 at 3:00 p.m. ET, to get the details of the FY 2019 Inpatient Prospective Payment System (IPPS) Proposed Rule, including proposed changes to rates, MS-DRG groupings, and inpatient quality initiatives.

    Register Here

    Register Here

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