The Patient-Centered Medical Home Poster Child

By James (Larry) Holly, M.D. on Dec 27, 2016 1:37:39 PM

By James (Larry) Holly, M.D., CEO, Southeast Texas Medical Associates

Southeast Texas Medical Associates’ (SETMA’s) pilgrimage toward Patient-Centered Medical Home (PCMH) began in 1999 as a result of our study of Peter Senge’s The Fifth Discipline. In that study, we identified ten principles which would guide our development in both our practice and in the electronic medical record (EMR) tool which we would design.  (see SETMA: May, 1999 - Four Seminal Events)  Ten years into our development, we realized that those ten principles were also the principles of PCMH.

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The Ultimate Hope of the Future of Healthcare is Transformation

By James (Larry) Holly, M.D. on Dec 15, 2016 11:40:01 AM

By James (Larry) Holly, M.D., CEO, Southeast Texas Medical Associates

To be successful, the implementation of new policies and initiatives that will produce the future we imagine must be transformative – which comes from within. 

Transformation results in change that is not simply reflected in shape, structure, dimension or appearance, but is also part of the nature of the organization being transformed. The process itself creates a dynamic which is generative. It not only changes that which is being transformed but it also creates within the object of transformation the energy, the will and the necessity to sustain and expand that change and improvement. Transformation is not dependent upon external pressure (rules, regulations, requirements) but is sustained by an internal drive which is energized by the evolving nature of the organization.

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3 Ways Healthcare Providers Can Protect Themselves from Cyber Attacks

By URAC Staff on Nov 23, 2016 3:08:20 PM

Hardly a month goes by that we don’t hear about a cyber or ransomware attack on a healthcare provider, manufacturer or health plan. Though major attacks are the ones that make the news, healthcare providers across the country face the risk of an attack of any size.

The Privacy Rights Clearinghouse estimates that more than 900 million records have been breached in the United States since 2005 as a result of nearly 5,200 reported incidents. Of those, about 30 percent—more than 1,500 data breaches—occurred in the healthcare industry.

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All Eyes On Vermont – At Least They Should Be

By Aaron Turner-Phifer, Vice President of Government Relations and Policy on Nov 9, 2016 9:00:00 AM

They say that “states are the laboratories of democracy.” In no place is this more evident than the state of Vermont’s efforts to radically change their healthcare delivery system.

On October 26, CMS and Vermont’s Green Mountain Care Board (GMCB) jointly announced the Vermont All-Payer Accountable Care Organization (ACO) Model. This new, first of its kind initiative is aimed at accelerating healthcare delivery reform for the entire state and its population by establishing a statewide ACO that is responsible for the health outcomes of its entire population.
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What Will Prevent ACOs from Failing?

By URAC Staff on Nov 8, 2016 11:55:34 AM

If physicians don’t understand MACRA – or think they don’t need to understand MACRA – how will ACOs get physician practices to align with the requirements of the Patient-Centered Medical Home (PCMH) model?

The transition from traditional fee-for-service to value-based payment models, and the focus on patient-centered medical care and population health, has driven the proliferation of Accountable Care Organizations (ACOs).
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Final MACRA Rule: Five Highlights You Need to Know

By URAC Staff on Oct 31, 2016 2:00:00 PM

With the final MACRA rule released on Oct. 14, the industry is now getting the chance to dig into all of the details of this 2,300-page document, especially the act’s Quality Payment Program, which replaces the Sustainable Growth Rate formula with two tracks of reimbursement—the Advanced Alternative Payment Models (APMs) or Merit-based Incentive Payment System (MIPS).

“Folks are now in the process of getting their heads around what’s in the final rule and determining what they have to do to respond in 2017,” said Aaron Turner-Phifer, URAC’s director of government relations and policy. “The most important thing right now is for practices and clinicians to be engaging with their medical societies and educating themselves on the best path forward.”

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Video: Are You Ready for MACRA?  Discover How to Achieve Sustainable Transformation

By URAC Staff on Oct 27, 2016 3:53:05 PM

Watch this video for quick overview about MACRA (Medicare Access and CHIP Reauthorization Act of 2015), and what you need to do to succeed in the new healthcare economy.

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3 Tips to Prepare Your Practice for PCMH Certification

By URAC Staff on Oct 26, 2016 5:00:00 AM

A foundational principle of all healthcare providers is to keep the focus on patients and their specific needs. It’s also the philosophy at the heart of the Patient-Centered Medical Home concept.

This concept and process can serve as invaluable guidance for transforming your practice, especially in the shift toward value-based reimbursement
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