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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).