workflow (Urupong Phunkoed/

Agencies sharpen processes, outcomes to improve efficiency

The Centers for Medicare and Medicaid is revamping the Quality Payment Program (QPP) for Medicare Services.  Kate Goodrich, director and chief medical officer at CMS, said changes to the program will make it easier for providers using alternative payment models.

Work at CMS is currently focused on building partnerships with commercial payers and states to help improve care.  The alternative payment model gives incentives to payments for high-quality and cost-efficient care; it can apply to specific clinical condition, a care episode or a population.

“We set a goal of reaching 30 percent of Medicare payments in two years from alternative payment models, and we met that target in early 2016,” Goodrich told the audience at the July 19 Professional Services Council's FedHealth Conference. “The new administration is spending a lot of time talking to external stakeholders on what is working well and what needs to be changed or tweaked, but we are much more focused on looking at the outcomes of care with patient experience and engagement.”

Goodrich identified three tenets for changing the CMS payment system: paying for care “based on value not volume,” incentivizing the “right care at the right time for the right patient” and making the information publicly available to give providers access to actionable information.

“We took an integrated-service approach for standing up QPP, where we have launched a whole new way of doing a service center or help desk,” Goodrich said. “We have a command center to be able to respond rapidly to what we are hearing from the public.”

CMS also recently launched a new website. It worked with U.S. Digital Service, employing user-centered design and agile development.

“[Agile development] is about us getting into the 21st century, but it was a huge change for us and a huge learning curve for us, our staff at CMS and our contractors,” Goodrich said. 

Goodrich said she sees agile and user-centered design as two competencies that “need to spread at CMS” and asked contractors for help to move forward with these initiatives. 

The Department of Veterans Affairs, meanwhile, is focusing on providing greater choices for veterans, modernizing systems, focusing resources, improving timeliness and suicide prevention.

Greg Giddens, executive director of the VA Office of Acquisition, Logistics and Construction, discussed some of the top priorities of VA Secretary David Shulkin, who joined in the agency in February 2017.

“We have struggled with interoperability for a long time, but now we have a path forward,” Giddens said during a keynote presentation, referring to the VA's recent decision to drop Vista, its homegrown electronic health record system, in favor of a commercial solution used by the Department of Defense.  “The secretary believes more information and transparency is better for us and for competition [between providers].”

The VA wants "to focus on the efforts that can be successful,” Carolyn Clancy, deputy undersecretary for health for organizational excellence at the Veterans Health Administration, said.

For example, VA could learn from CMS' Nursing Home Compare website, which allows Medicare users to evaluate nursing homes based on data collected by CMS. VA could build a similar site that makes veterans aware of different offerings. 

“Nursing Home Compare is heavily trafficked site, so our hope and expectation is that we could see something similar with our own sites,” Clancy said.  “We don’t have all of their quality of measures on our sites though, so we are going to continue to do more work on what could be most useful for patients.”

About the Author

Sara Friedman is a reporter/producer for GCN, covering cloud, cybersecurity and a wide range of other public-sector IT topics.

Before joining GCN, Friedman was a reporter for Gambling Compliance, where she covered state issues related to casinos, lotteries and fantasy sports. She has also written for Communications Daily and Washington Internet Daily on state telecom and cloud computing. Friedman is a graduate of Ithaca College, where she studied journalism, politics and international communications.

Friedman can be contacted at [email protected] or follow her on Twitter @SaraEFriedman.

Click here for previous articles by Friedman.


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