2017 HSC Section 2 - Practice Management

TABLE OF CONTENTS Selected Recent Materials - Reproduced in this Study Guide

SECTION 2: PRACTICE MANAGEMENT November 2017

ADDITIONAL REFERENCE MATERIAL .......................................................................................i - iv

I.

Practice Management A. Quality measures (definition, PQRS) Bekelis K, McGirt MJ, Parker SL, et al. The present and future of quality measures and public reporting in neurosurgery. Neurosurg Focus . 2015; 39(6):E3. EBM level NA............................................................................................................................1-7 Summary : This article summarizes recent changes to physician reimbursement that have been implemented by Centers for Medicare and Medicaid Services (CMS) and those that are in process. Specifically, the authors review how quality is defined and how the changes affect physician practices. The article discusses the use of registries, certified electronic health record technology (CEHRT), and Value-Based Payment Modifier (VM) in determining physician fee schedules. Last, it discusses how the Medicare Access and CHIP Reauthorization Act (MACRA) will use the Merit-Based Incentive Payment System (MIPS) to determine bonus payments and penalties. Vila PM, Schneider JS, Piccirillo JF, Lieu JE. Understanding quality measures in otolaryngology-head and neck surgery. JAMA Otolaryngol Head Neck Surg . 2016; 142(1):86-90. EBM level 5............................................................................................8-12 Summary : This article explores pay-for-performance models in otolaryngology. The article covers historical development, various models, and approaches to creating effective performance measures. B. Physician reimbursement (MACRA, MIPS) Miller P, Mosley K. Physician reimbursement: from fee-for-service to MACRA, MIPS and APMs. J Med Pract Manage . 2016; 31(5):266-269. EBM level NA.................13-16 Summary : This article provides information on how healthcare reimbursement has changed over the years, with a focus on the upcoming changes as outlined by the Medicare Access and CHIP Reauthorization Act (MACRA) and how it would impact physician reimbursement. The authors provide an overview of the Merit-Based Incentive Payment System (MIPS) as well as Alternative Payment Models (APMs).