Earlier this month, my practice converted from the Allscripts Professional PM and EHR system to athenaOne. If you have been through this process, you know it is not easy. Many have come to tears or left their job when going through a system conversion because of the stress of balancing seeing patients while learning a new system. While lessons were learned and there were hiccups along the way, our process went smoothly with only a 3-week ramp-up period.

As we continue our series discussing Accountable Care Organizations, or ACOs, we now move from the topic of forming your own ACO to what are some key questions to ask before joining an existing ACO. Entering an existing ACO can be a lucrative and well aligned way to accomplish success in value based care for your MSSP patients, but you may find yourself facing buyers’ remorse if you don’t go in well-informed. If you do make a decision that doesn’t align with your practice’s priorities and goals, you will be locked into the model for at least one year, possibly more, depending on the terms of your agreement.

If you are a primary care practice, you’re most likely aware of the CMS directive to have all Medicare fee-for-service beneficiaries in an arrangement that includes accountability for quality and total cost of care by 2030. You’ve also most likely been approached within the last few weeks about joining an Accountable Care Organization (ACO), likely by multiple different groups, or you’ve done research and heard about ACOs recently. With Phase 1 of the ACO application period of May 18, 2023 through June 15, 2023 and Phase 2 July 11, 2023 through August 1, 2023, being aware of the deadlines is important, but even more important is being prepared to succeed in an ACO, and making the decision to even join one for the 2024 performance year.

With cold and flu season winding down, now is a great time to schedule classes, webinars, or conferences that will count towards the CEU and CME requirement for the providers and staff in your practice.

Health equity has become a topic of increased awareness and interest in the last several years, and CMS has most assuredly taken notice. Before you think that this is not my practice, not my concern, and not something I have to worry about, it’s best to be informed of what health equity is, what CMS is doing about it, and why health equity matters at your practice.

The CMS Innovation Center (CMMI) has produced many directives recently, many of which deal with the future of value based care. A 2021 strategy statement summarized the vision of CMMI, with these two statements showing how to measure progress.

With the public health emergency and the impact of Covid on the overall workforce, we’ve all become even more familiar with terms such as “The Great Resignation” and “toxic culture”. Especially in the overburdened healthcare industry, with many clinical and support areas experiencing shortages of employees or shifts in employee responsibilities, the topic of workplace culture has become even more critical.

Does the culture of a practice impact the quality of care a patient receives? Research shows it does. It is well known that engaged employees are more productive and have greater job satisfaction. Let's look at how culture can help an organization achieve higher quality care for their patients. According to Merriam-Webster, culture is "the set of shared attitudes, values, goals, and practices that characterizes an institution or organization". If a practice is solely focused on volume and revenue with no regard for the providers and team, the result is likely a negative culture with burnout and high turnover rates.

Imagine this.

You’re in a new city for a trip, and have checked in to your hotel for the stay. It’s close to dinner time, and you are ready to go out and eat. What do you do? If you’re like most people, you’ll open up one of many websites or apps, such as Google, Yelp, Facebook, or others, and search for dining options near you. You’ll likely look at which ones are the closest options, then see what type of restaurant strikes you.

Primary care, and the leaders, physicians, clinicians, and support team within those primary care offices, are truly at the heart of making healthcare better. As we close out 2022 and enter 2023, there is no better time to focus on something that’s often overlooked in the business of primary care - you and your intentions.

It seems everywhere you look now, self-service is present from self-check-outs to ordering and paying using a QR code at a restaurant. Self-service, or the digital front door, became even more prominent with the COVID pandemic to reduce face-to-face interactions and the spread of the virus. Healthcare has had self-service options for patients for some time now through patient portals but these options are continually expanding to allow patients to interact with their healthcare team in the way they prefer. These methods can include self-scheduling, text messages to request an appointment or change an existing appointment, paying bills, completing health assessments before arriving at the office, and checking in for an appointment prior to arrival.

The National Committee for Quality Assurance (NCQA) has developed a list of metrics and measures they consider pertinent to the assessment of quality in the delivery of healthcare based on access, availability, effectiveness, and outcomes

Data in healthcare is now essentially ubiquitous: there are mountains of it everywhere. With the promise of tech and big data, healthcare systems snapped up technology that promised to capture all their data and provide enhanced and unprecedented insights. EHRs were pushed on physicians, claiming better data collection, organization, and utilization.

A misconception exists that physicians must choose between practicing fee-for-service (FFS) medicine and Value-based Care (VBC). We often hear the phrase "a foot in two canoes" to represent the perceived need to abandon one watercraft for another identical one in their move to VBC, the notion being you can't simultaneously be in both payment models, and you need to choose. This perception can be paralyzing when considering making a business move within one of these practice / delivery models.

While it’s nearly impossible to attribute just one, or even a handful of causes to the lack of traction or success for value-based care, it is possible to assess influence and recommend focused avenues for positive change.