*A newer piece is available on NCQA PCMH 2025 annual reporting standards and guidelines .  The National Committee for Quality Assurance (NCQA) consistently strives to enhance the quality of healthcare and improve patient outcomes. With the changing Patient-Centered Medical Home (PCMH) 2025 annual reporting requirements, it’s essential for healthcare professionals, providers and administrators to stay updated on the latest developments to enhance quality care and patient outcomes.  Here, DataGen’s Mandi Diamond, senior practice transformation advisor, covers the three biggest changes you need to know about for next year's annual PCMH reporting related to quality improvement worksheets, the importance of diverse patient examples in care management plans and enhanced communication protocols.    Let’s dive into the most important PCMH reporting requirement changes.   1. Re-introduction of the mini quality improvement worksheet  One significant update is th...

A common misconception in healthcare practices: Organizations can quickly reap the benefits of value-based payment transformation. To launch a successful value-based payment program , practices must implement a variety of foundational pieces. It may take time, resources and data before a practice can successfully engage in VBP. In this blog, we'll cover what goes into VBP and its potential benefits. We'll also dig deeper into practice advancement strategies and how they can help you achieve your practice goals. What goes into VBP? Many practices want to implement VBP because of its payment structure and return on investment. Yet, they might not consider how to nurture a successful VBP program in their organization. It starts with a gap analysis regarding people, processes and technologies. It’s important to celebrate what is working well and intervene where improvement can be made. Successful VBP starts with the practice team. There are many perceptions vs. realities that exist...

Are you a primary care practice that’s considering joining the Making Care Primary model? If so, you may have concerns about the experience needed to participate in a value-based care model. In this blog post, we’ll explore whether VBC experience is a requirement to apply for MCP and what benefits you can expect from the program, regardless of your experience level. Is value-based care experience required for MCP? Primary care providers don’t need VBC experience to apply for MCP. However, since MCP is a multi-state initiative , you do need to be located in one of the following states: Colorado; Massachusetts; Minnesota; New Jersey; New Mexico; New York; North Carolina; or Washington. Note, in New York only upstate counties are included under the model. See Appendix D in the Making Care Primary Request for Applications for more information.  Is there an advantage for practices with little to no VBC experience? One of the key benefits of the model is that primary care providers who...

CMS’ Bundled Payments for Care Improvement Advanced program will soon kick off a two-year program extension through 2025. Model Year 7 (Jan. 1 - Dec. 31, 2024) will be the first time that current participants (acute care hospitals and physician groups) can update their episode of care selections since 2020. MY7 is also only the second time since BPCIA launched (2018) that CMS will allow new providers to join. Applications were due May 31, 2023. Whether you’re a new applicant or a current participant looking to update your episode selections to improve results, it’s never too early to prepare. BPCIA participants take on immediate full risk. This makes it critical to choose episodes that present the greatest savings, incentive and quality improvement opportunities. Episode selection — An art and a science For optimal BPCIA episode selection, providers must analyze their performance from the historic baseline period and design their clinical effectiveness strategies accordingly. It’s impo...

Everybody knows: Conferences aren’t just about what you learn but who you meet. Anyone attending the annual National Association of ACOs conference this week in Baltimore should take full advantage of the experts in attendance. This will include executives from leading accountable care organizations, private payers and CMS. NAACOS 2023 will zero in on what you need to know now and who best to learn it from. That includes the industry partners who have helped build incentive-generating infrastructure for the past decade’s most successful ACOs. Analytics first, last and everywhere If there’s any question as to what ACOs need to succeed with alternative payment models, simply look at the topic of NAACOS’ opening session: advanced analytics. There isn’t a single aspect of value-based care that doesn’t happen without analytics: better prevention and primary care; enhanced care coordination; managing risk; benchmarking; and a stronger bottom line. NAACOS sessions will detail these topics wi...

To build a better medical practice, you must transform and then sustain the change. Through customized engagements and best practice experience, Practice Advancement Strategies guides clinical teams through the following challenges and opportunities: staff shortages/burnout; practice culture; payer negotiation and contracting; and value-based care outcomes These will be hot topics at the next Medical Group Management Association event: the Medical Practice Excellence: Financial and Operations Conference , just around the corner in Orlando, March 19-21. To help you prepare — for the conference or progress in general — DataGen Practice Advancement Strategies offers the following insider tips for practice advancement. 1.   Transformed teams can transform patient care. Research shows that earning Patient-Centered Medical Home Recognition from the National Committee for Quality Assurance can reduce staff burnout by more than 20%. While workforce shortages clearly impact burnout, c...