PYA Offers Guide to Medicare Physician Value Modifier Program

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The latest white paper from national healthcare consulting firm PYA provides a straight-forward, easy-to-follow guide to help physicians navigate the Medicare Physician Value Modifier Program and thrive under emerging value-based payment models.

Pershing Yoakley & Associates Offers Guide to Medicare Physician Value Modifier Program

Practical Guide to the Medicare Physician Value Modifier Program

This guide is designed to help physician groups proactively identify and implement strategies to help improve their VM Program scores

The recent announcement that the U.S. Department of Health and Human Services intends to have 85% of all Medicare fee-for-service payments tied to quality or value by 2016, and 90% by 2018 eliminates any doubt that value-based payment models are here to stay.

With the rollout of the Medicare Physician Value Modifier Program (VM Program) this year, the Centers for Medicare & Medicaid Services (CMS) aims to reward physicians for providing value—delivering high-quality care in an efficient manner—to Medicare beneficiaries. Using specific measures for quality and efficiency, CMS will compare physician groups and adjust their Medicare Physician Fee Schedule (MPFS) payments up or down based on the results of that comparison.

The first step to success under the VM Program is to have a clear understanding of how it operates. To this end, PYA has developed a straightforward guide which answers some of the most frequent questions asked by physician groups about the program.

Arranged in a simple Q&A format, “The Practical Guide to the Medicare Physician Value Modifier Program” provides a VM Program summary, information about calculating composite scores, and tables that demonstrate the upward/downward payment adjustments. It also outlines a “to-do list” of six tasks that physician groups should perform now to best prepare for the VM program.    

“It’s ‘game on’ and performance matters,” said PYA Principal Martie Ross, one of the authors of the guide. “Medicare physician value-based purchasing is here, and Medicare payments to physicians now will be affected based on a physician group’s ability to meet these performance metrics as compared to their peers. Better scores mean higher reimbursement, but more importantly, directly impact a practice’s reputation with other providers, payers, and patients. This guide is designed to help physician groups proactively identify and implement strategies to help improve their VM Program scores.”

PYA recently offered a four-part educational series, “Physician Value-Based Payments—What You Don’t Know Can Hurt You,” which explained CMS’ physician value-based payment initiatives and highlighted what providers can do to ensure success. Additional guidance from PYA related to the Medicare Physician Fee Schedule may be found in its recent white paper, “Providing and Billing Medicare for Chronic Care Management-2015 Medicare Physician Fee Schedule Final Rule.”

PYA assists physician groups by providing educational sessions tailored to their needs, analyzing Quality and Resource Use Reports (QRURs) for opportunities, and developing and implementing Physician Quality Reporting System (PQRS) success strategies.

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About PYA

For over three decades, Pershing Yoakley & Associates (PYA) has provided timely insight, strategic support, and exceptional professional service, helping clients thrive in the midst of rapid change. PYA is ranked by Modern Healthcare as the nation’s twelfth largest privately held healthcare management consulting firm. For more information, visit http://www.pyapc.com/.

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Ed Pershing

Ed Pershing
PYA
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