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Get on board with APMs or risk having your practice commoditized
Gastroenterologists need to get on board with assuming risk through the adoption of advanced alternative payment methods under Medicare’s new Quality Payment Program or risk losing money through the commoditization of their services.
That’s the message Lawrence Kosinski, MD, of the Illinois Gastroenterology Group, has for his fellow gastroenterologists.
“To me, MIPS [Merit-based Incentive Payment System] is just an extension of what we were doing with PQRS and meaningful use, value-based modifiers,” Dr. Kosinski, who serves as practice councillor on the AGA Governing Board, said in an interview in advance of his presentation at the 2017 AGA Tech Summit sponsored by the AGA Center for GI Innovation and Technology.
If gastroenterologists choose to stay on that path rather than accept the two-sided risk of following the APM track of the Quality Payment Program, “you are going to have commoditized services and you are going to just make less money and work for somebody else. But if you want to be in control of your own future, we have to strive to work in [the APM] direction.”
To get there, the culture of gastroenterology will need to shift.
“Our culture right now is one where we get paid for making widgets,” he said. “And the more widgets we make, the more money we make. The more colonoscopies we do, the more money we make. The more we can charge for those colonoscopies and get collected, the better things are for us.”
The future could allow gastroenterologists to charge for more and different services, he added.
“A lot of people are working to replace colonoscopies with much less expensive alternative,” Dr. Kosinski said. “So where does a gastroenterologist have a competitive advantage? It’s in the knowledge of these complex diseases that are running up the cost of health care. Over 80% of the cost of health care is for the management of chronic disease. We happen to have a very expensive set of chronic diseases that we take care of in GI, very complicated illnesses. We need to leverage that. We need to leverage the management of those patients, but we need to be able to show how our work decreases the overall cost of care so that we can get a piece of that risk premium.”
He warned: “If we don’t do that, we’re just going to be commoditized proceduralists.”
And the upside will be better reimbursements for doctors and lower overall costs for health systems.
“We may be able to increase our own reimbursement as long as we are critical in lowering the overall cost of care for the entire population,” he said.
To that end, “well-managed GI practices should be able to develop a competitive advantage in a value space to be able to supply the needed services,” he said, adding that “we’re going to have to provide value by improving quality through a focus on patient outcomes. We have to assure a new level of patient relationships and ultimately focus on lowering the cost of care for a population of patients.”
Gastroenterologists need to get on board with assuming risk through the adoption of advanced alternative payment methods under Medicare’s new Quality Payment Program or risk losing money through the commoditization of their services.
That’s the message Lawrence Kosinski, MD, of the Illinois Gastroenterology Group, has for his fellow gastroenterologists.
“To me, MIPS [Merit-based Incentive Payment System] is just an extension of what we were doing with PQRS and meaningful use, value-based modifiers,” Dr. Kosinski, who serves as practice councillor on the AGA Governing Board, said in an interview in advance of his presentation at the 2017 AGA Tech Summit sponsored by the AGA Center for GI Innovation and Technology.
If gastroenterologists choose to stay on that path rather than accept the two-sided risk of following the APM track of the Quality Payment Program, “you are going to have commoditized services and you are going to just make less money and work for somebody else. But if you want to be in control of your own future, we have to strive to work in [the APM] direction.”
To get there, the culture of gastroenterology will need to shift.
“Our culture right now is one where we get paid for making widgets,” he said. “And the more widgets we make, the more money we make. The more colonoscopies we do, the more money we make. The more we can charge for those colonoscopies and get collected, the better things are for us.”
The future could allow gastroenterologists to charge for more and different services, he added.
“A lot of people are working to replace colonoscopies with much less expensive alternative,” Dr. Kosinski said. “So where does a gastroenterologist have a competitive advantage? It’s in the knowledge of these complex diseases that are running up the cost of health care. Over 80% of the cost of health care is for the management of chronic disease. We happen to have a very expensive set of chronic diseases that we take care of in GI, very complicated illnesses. We need to leverage that. We need to leverage the management of those patients, but we need to be able to show how our work decreases the overall cost of care so that we can get a piece of that risk premium.”
He warned: “If we don’t do that, we’re just going to be commoditized proceduralists.”
And the upside will be better reimbursements for doctors and lower overall costs for health systems.
“We may be able to increase our own reimbursement as long as we are critical in lowering the overall cost of care for the entire population,” he said.
To that end, “well-managed GI practices should be able to develop a competitive advantage in a value space to be able to supply the needed services,” he said, adding that “we’re going to have to provide value by improving quality through a focus on patient outcomes. We have to assure a new level of patient relationships and ultimately focus on lowering the cost of care for a population of patients.”
Gastroenterologists need to get on board with assuming risk through the adoption of advanced alternative payment methods under Medicare’s new Quality Payment Program or risk losing money through the commoditization of their services.
That’s the message Lawrence Kosinski, MD, of the Illinois Gastroenterology Group, has for his fellow gastroenterologists.
“To me, MIPS [Merit-based Incentive Payment System] is just an extension of what we were doing with PQRS and meaningful use, value-based modifiers,” Dr. Kosinski, who serves as practice councillor on the AGA Governing Board, said in an interview in advance of his presentation at the 2017 AGA Tech Summit sponsored by the AGA Center for GI Innovation and Technology.
If gastroenterologists choose to stay on that path rather than accept the two-sided risk of following the APM track of the Quality Payment Program, “you are going to have commoditized services and you are going to just make less money and work for somebody else. But if you want to be in control of your own future, we have to strive to work in [the APM] direction.”
To get there, the culture of gastroenterology will need to shift.
“Our culture right now is one where we get paid for making widgets,” he said. “And the more widgets we make, the more money we make. The more colonoscopies we do, the more money we make. The more we can charge for those colonoscopies and get collected, the better things are for us.”
The future could allow gastroenterologists to charge for more and different services, he added.
“A lot of people are working to replace colonoscopies with much less expensive alternative,” Dr. Kosinski said. “So where does a gastroenterologist have a competitive advantage? It’s in the knowledge of these complex diseases that are running up the cost of health care. Over 80% of the cost of health care is for the management of chronic disease. We happen to have a very expensive set of chronic diseases that we take care of in GI, very complicated illnesses. We need to leverage that. We need to leverage the management of those patients, but we need to be able to show how our work decreases the overall cost of care so that we can get a piece of that risk premium.”
He warned: “If we don’t do that, we’re just going to be commoditized proceduralists.”
And the upside will be better reimbursements for doctors and lower overall costs for health systems.
“We may be able to increase our own reimbursement as long as we are critical in lowering the overall cost of care for the entire population,” he said.
To that end, “well-managed GI practices should be able to develop a competitive advantage in a value space to be able to supply the needed services,” he said, adding that “we’re going to have to provide value by improving quality through a focus on patient outcomes. We have to assure a new level of patient relationships and ultimately focus on lowering the cost of care for a population of patients.”
Real-time data, transparency needed to improve safety
With an increasing number of emerging technological advances in both medical devices and procedures, two factors will help improve safety and outcomes for patients: better real-time data and information transparency.
And the key to getting that data will be broader use of registries, according to Dana Telem, MD, director of the Comprehensive Hernia Program at the University of Michigan, Ann Arbor.
Dr. Telem will discuss the importance of real-time information and registries during her April 13 presentation at the 2017 AGA Tech Summit, sponsored by the AGA Center for GI Innovation and Technology.
Speaking in advance of the meeting, Dr. Telem noted that understanding value and finding potential safety issues are among the reasons for using data registries.
“I think that’s really why we need to focus on getting real-time data and that’s why I think registry efforts are so important,” she said. “What registries are really great at [is] identifying those isolated events.”
In addition, they help with another key concept she will highlight during her talk: transparency, something that is especially important as new techniques and devices are introduced.
“We understand that there are going to be early adopters, and you need to have the pioneers in order to take those next steps,” she said.
But to get the most out of those new technologies, data need to be recorded not only for short-term outcomes but over the long term as well “so that we can really assess the value of the techniques or the devices that we are putting out into the community.”
And by providing transparency on what is known, as well as unknown, it also helps patients in making their own decisions on whether to proceed with something new.
She believes that, especially when it comes to newer technologies, patients will be willing to be a part of that data collection if doctors are transparent.
“Many people are willing as long as you are honest with them,” Dr. Telem said. “I think particularly that when newer devices and techniques come out, particularly endoscopic procedures that can save them an operation, they are more willing than not, oftentimes, to do it, which is also where it gets a little bit dangerous if you are not transparent.”
But even being transparent can be a challenge.
“I think a lot of the issue that we have in health care is what type of information we are providing and how are we providing it, and is the receiver of information actually understanding what we are saying?” she pondered.
“I don’t think we know the answers to that, but I think part of the solution at least is to be as open about what we know as well as what we don’t know at the same time and let the patient make a decision based on their value system,” she continued. “A lot of times with these newer technologies or techniques, you really have to sit down with the patient and ask them about their long-term goals, what are acceptable and unacceptable outcomes.”
Recognizing the importance of data registries, in 2014 AGA launched a new initiative working as a neutral, objective broker to establish clinical research studies. Through this program, AGA collects important data to assess the value of new technologies and procedures on patient care. Ultimately, the data AGA collects will support the approval, coverage, and adoption of new technologies that demonstrate promise and merit. To learn more about AGA’s registry initiative or get involved, please contact Sonya Serra, AGA’s senior director of registry development and integrity, at [email protected].
With an increasing number of emerging technological advances in both medical devices and procedures, two factors will help improve safety and outcomes for patients: better real-time data and information transparency.
And the key to getting that data will be broader use of registries, according to Dana Telem, MD, director of the Comprehensive Hernia Program at the University of Michigan, Ann Arbor.
Dr. Telem will discuss the importance of real-time information and registries during her April 13 presentation at the 2017 AGA Tech Summit, sponsored by the AGA Center for GI Innovation and Technology.
Speaking in advance of the meeting, Dr. Telem noted that understanding value and finding potential safety issues are among the reasons for using data registries.
“I think that’s really why we need to focus on getting real-time data and that’s why I think registry efforts are so important,” she said. “What registries are really great at [is] identifying those isolated events.”
In addition, they help with another key concept she will highlight during her talk: transparency, something that is especially important as new techniques and devices are introduced.
“We understand that there are going to be early adopters, and you need to have the pioneers in order to take those next steps,” she said.
But to get the most out of those new technologies, data need to be recorded not only for short-term outcomes but over the long term as well “so that we can really assess the value of the techniques or the devices that we are putting out into the community.”
And by providing transparency on what is known, as well as unknown, it also helps patients in making their own decisions on whether to proceed with something new.
She believes that, especially when it comes to newer technologies, patients will be willing to be a part of that data collection if doctors are transparent.
“Many people are willing as long as you are honest with them,” Dr. Telem said. “I think particularly that when newer devices and techniques come out, particularly endoscopic procedures that can save them an operation, they are more willing than not, oftentimes, to do it, which is also where it gets a little bit dangerous if you are not transparent.”
But even being transparent can be a challenge.
“I think a lot of the issue that we have in health care is what type of information we are providing and how are we providing it, and is the receiver of information actually understanding what we are saying?” she pondered.
“I don’t think we know the answers to that, but I think part of the solution at least is to be as open about what we know as well as what we don’t know at the same time and let the patient make a decision based on their value system,” she continued. “A lot of times with these newer technologies or techniques, you really have to sit down with the patient and ask them about their long-term goals, what are acceptable and unacceptable outcomes.”
Recognizing the importance of data registries, in 2014 AGA launched a new initiative working as a neutral, objective broker to establish clinical research studies. Through this program, AGA collects important data to assess the value of new technologies and procedures on patient care. Ultimately, the data AGA collects will support the approval, coverage, and adoption of new technologies that demonstrate promise and merit. To learn more about AGA’s registry initiative or get involved, please contact Sonya Serra, AGA’s senior director of registry development and integrity, at [email protected].
With an increasing number of emerging technological advances in both medical devices and procedures, two factors will help improve safety and outcomes for patients: better real-time data and information transparency.
And the key to getting that data will be broader use of registries, according to Dana Telem, MD, director of the Comprehensive Hernia Program at the University of Michigan, Ann Arbor.
Dr. Telem will discuss the importance of real-time information and registries during her April 13 presentation at the 2017 AGA Tech Summit, sponsored by the AGA Center for GI Innovation and Technology.
Speaking in advance of the meeting, Dr. Telem noted that understanding value and finding potential safety issues are among the reasons for using data registries.
“I think that’s really why we need to focus on getting real-time data and that’s why I think registry efforts are so important,” she said. “What registries are really great at [is] identifying those isolated events.”
In addition, they help with another key concept she will highlight during her talk: transparency, something that is especially important as new techniques and devices are introduced.
“We understand that there are going to be early adopters, and you need to have the pioneers in order to take those next steps,” she said.
But to get the most out of those new technologies, data need to be recorded not only for short-term outcomes but over the long term as well “so that we can really assess the value of the techniques or the devices that we are putting out into the community.”
And by providing transparency on what is known, as well as unknown, it also helps patients in making their own decisions on whether to proceed with something new.
She believes that, especially when it comes to newer technologies, patients will be willing to be a part of that data collection if doctors are transparent.
“Many people are willing as long as you are honest with them,” Dr. Telem said. “I think particularly that when newer devices and techniques come out, particularly endoscopic procedures that can save them an operation, they are more willing than not, oftentimes, to do it, which is also where it gets a little bit dangerous if you are not transparent.”
But even being transparent can be a challenge.
“I think a lot of the issue that we have in health care is what type of information we are providing and how are we providing it, and is the receiver of information actually understanding what we are saying?” she pondered.
“I don’t think we know the answers to that, but I think part of the solution at least is to be as open about what we know as well as what we don’t know at the same time and let the patient make a decision based on their value system,” she continued. “A lot of times with these newer technologies or techniques, you really have to sit down with the patient and ask them about their long-term goals, what are acceptable and unacceptable outcomes.”
Recognizing the importance of data registries, in 2014 AGA launched a new initiative working as a neutral, objective broker to establish clinical research studies. Through this program, AGA collects important data to assess the value of new technologies and procedures on patient care. Ultimately, the data AGA collects will support the approval, coverage, and adoption of new technologies that demonstrate promise and merit. To learn more about AGA’s registry initiative or get involved, please contact Sonya Serra, AGA’s senior director of registry development and integrity, at [email protected].