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Reimbursement and Practice Management

Single Aim at Triple Aim

Maybe, just maybe, if specialty physicians, care teams and business and clinical support teams can stay true to their focus on the patient amidst the distractions of complex reporting requirements — aiming at compliance with the requirements of the Triple Aim won't seem nearly as ominous.

In specialty care, having the right patient get to the right provider at the right time for the right care in the right place of service theoretically provides a solid foundation for meeting the CMS requirements for QPP through MACRA APMs and MIPS. Translating specialty care "rightness" into the complex government payer requirements can be a challenge. Choosing the right qualified reporting mechanism with the right measures is essential for specialists. Specialty societies, qualified EHR vendors and QCDRs are finding ways to bridge the gaps between doing "what's right" for the patient and getting credit for doing it.

Noteworthy, CMS has been listening to provider groups. CMS has established first year participation simplifications and options. "How-to" meet MIPS requirements now includes "pick your pace" by either testing (trying it), partial reporting or full reporting.

Maybe, just maybe, the focus on "patient first" will become easier. The Triple Aim can then remain a single aim — getting the right patient to the right provider at the right time for the right care in the right place of service.

United States