The value transformation of health care: Impact on neuromuscular and electrodiagnostic medicine

Abstract

Beginning in 2017, most physicians who participate in Medicare are subject to the Medicare Access and CHIP Reauthorization Act (MACRA), the milestone legislation that signals the US health care system's transition from volume-based to value-based care. Here we review emerging trends in development of value-based healthcare systems in the US. MACRA and the resulting Quality Payment Program create 2 participation pathways, the Merit-based Incentive Payment System (MIPS) and the Advanced Alternative Payment Model (AAPM) pathway. Although there are several program incentives for AAPM participation, to date there have been few AAPM options for specialists. MIPS and its widening bonus and penalty window will likely be the primary participation pathway in the early years of the program. Value-based payment has the potential to reshape health care delivery in the United States, with implications for neuromuscular and electrodiagnostic (EDX) specialists. Meaningful quality measures are required for neuromuscular and EDX specialists.Muscle Nerve 56: 679-683, 2017 SGR, sustainable growth rate; VBPM, value-based payment modifier

A Shortage of Neurologists – We Must Act Now

“…For example, the innovative practice models described above require a viable compensation model that addresses implementation and sustainability. Most current APMs are designed for primary care, not specialist practices 66 ; however, the Physician-Focused Payment Model Technical Advisory Committee, a federal task force, is utilizing specialists to propose and develop advanced APMs. 67 We applaud the AAN for being an early proposer of an APM of multidisciplinary headache management and encourage further engagement for other neurologic conditions.…”

Quality measures in electrodiagnosis: Carpal tunnel syndrome—An AANEM Quality Measure Set

“…Value is defined as healthcare outcomes achieved per dollar spent . The Centers for Medicare and Medicaid Services (CMS) implemented the Quality Payment Program (QPP) as a steady transition to value‐based programs after the Medicare Access and CHIP Reauthorization Act was signed into law in 2015, although the stage for this transition was set by the Affordable Care Act of 2010 . The reporting of performance on quality measures is an integral part of the QPP, and clinician payments are linked to the ability to demonstrate adherence to quality measures.…”

Quality measures: Do they measure up?

“…The Affordable Care Act of 2010 accelerated the pace toward value‐based care . The Medicare Access and Chip Reauthorization Act of 2015 (MACRA) further defined a fundamental repositioning from volume‐based to value‐based payment programs …”