BOSTON, May 9, 2016 /PRNewswire/ --
- Health Systems need to optimize performance of physicians and other eligible providers (EPs) in their network based on the quality, resource use and other criteria defined in the proposed MACRA rule
- ConvergeHEALTH Network Insight™ is preconfigured to assess EP current performance against the MACRA MIPS weighted composite scoring criteria in advance of the proposed Jan 1, 2017 start date for the initial performance period
- Deloitte provides dynamic scenario modeling on the proposed MACRA MIPS measures and network adequacy to support qualifying advanced payment models (APMs) for readiness and planning purposes
Providers are in the process of understanding, preparing and responding to the rules and enterprise business implications of the Medicare Access & CHIP Reauthorization Act (MACRA). ConvergeHEALTH Network Insight coupled with the knowledge and experience of Deloitte's broad value-based care services, enables health care providers to thrive in a post-MACRA environment. Network Insight is preconfigured to estimate and assess eligible providers (EPs) against the proposed MACRA Merit-Based Incentive Payment System (MIPS) composite scoring methodology. This allows clients to determine and deploy interventions with primary care practitioners and specialists that facilitate maximum reimbursement for quality, outcomes-centered, cost-appropriate care.
"The proposed MACRA rule creates a pathway for providers to receive higher Medicare payments, or avoid negative payment adjustments, largely through the MIPS consolidated and expanded incentive program," said Dorrie Guest, director, Deloitte Consulting, LLP, and U.S. physician enterprise and ambulatory services leader. "It will be essential for health care providers to calculate accurate composite scores and use guided analytics to derive insights from their data for a deep understanding of positioning against proposed rule payment adjustments. Providers that take advantage of these insights can position themselves to optimize their performance and maximize reimbursement opportunities under MACRA."
"ConvergeHEALTH Network Insight has already helped many of our health care clients through innovative approaches to physician and ambulatory services network development," said, Courtney Thayer, principal, Deloitte Consulting LLP, and ConvergeHEALTH health care leader. "Now with the ability to analyze and provide insights out of the box on individual performance against the proposed MIPS scoring criteria and network adequacy for APMs, we will help our clients navigate this changing landscape and thrive in this new reimbursement model."
Network Insight is a hybrid solution that delivers a 6:1 to 9:1 ROI through a virtually unmatched combination of analytics, services, and products supporting the physician and ambulatory services aspects of the volume to value journey. The guided analytics, paired with Deloitte Consulting services, can accelerate strategic decision making and operational interventions to improve performance in the post-MACRA environment. Further, Network Insight™ outputs, coupled with Deloitte Advisory's industry leading Regulatory and Compliance services, can support providers as they manage their MACRA related CMS compliance exposure.
"The ability to estimate and assess eligible providers against proposed MACRA MIPS composite scoring methodology gives our clients a baseline for understanding their CMS compliance posture while preparing them to adopt qualifying APMs," said Anne Phelps, principal, Deloitte & Touche LLP, and Deloitte Advisory's U.S. health care regulatory leader.
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- Asset: Network Insight Network Optimizer – Performance Value Scoring & Network Adequacy
- Video: Optimizing Physician Networks
About ConvergeHEALTH by Deloitte
ConvergeHEALTH brings powerful, demonstrated analytics platforms and data models. We use advanced proprietary and open source analytics, content and benchmarks through collaboration with industry leaders and deep experiences from Deloitte's Life Sciences and Health Care consulting practice to help our clients survive and thrive in the new paradigm of value-based, personalized medicine. For more information, visit www.converge-health.com.
As used in this document, "Deloitte" refers to one or more of Deloitte Touche Tohmatsu Limited, a UK private company limited by guarantee, and its network of member firms, each of which is a legally separate and independent entity. Please see www.deloitte.com/about for a detailed description of the legal structure of Deloitte Touche Tohmatsu Limited and its member firms.
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