Issue Definition and Background and Situation Description Dr. Jane Doe has parti

Question

Issue Definition and Background and Situation Description

Dr. Jane Doe has participated in quality initiatives, but nothing very formal, and she has not submitted any data. Without anything formal, and with the passing of MACRA as it is proposed, she will not be able to bill for Medicare services unless she changes her practice.

•             Some physicians have decided to be employed by larger group practices, and have the impacts of MACRA dealt with at the group level.

•             Some physicians have decided to manage the quality data and reporting on their own.

•             Some physicians have decided to affiliate with an ACO, and participate in alternative payment models that would comply with the MACRA guidelines.

Options Available to Dr. Jane Doe

Dr. Doe has decided not to become employed by a larger group, so based on your research with the options to comply with MACRA (and the information listed above), you will determine that she only has 2 choices. Below, please list the options, and pros and cons to each.

Option 1:

Pros to option 1:

Cons to option 1:

Option 2:

Pros to option 2:

Cons to option 2:

Dr. Doe's Proposed Strategy

Now Choose one of the options above as your recommendation:

Recommendation:

Based on the Strategic Initiative that you chose, define a goal for the physician:

Goal:

Based on the Goal that you chose, define at least 3 objectives:

Objective:

Objective:

Objective:

Measurement Criteria: Below, list at least 3 measurement criteria.

1.           

2.           

3.           

Barriers and Constraints: Below, list at least 2 potential barriers and constraints.

1.           

2.   

Explanation / Answer

The options are:

- Some physicians have decided to manage the quality data and reporting on their own.

Pros: *Physician are free from lot of interference and provide the quality care they desire.

* Appropriate results from the data base analyzed and disseminated to meet the concerns of each decision maker.

Cons: * There is no definite connotation amid visit length and consequences of chronic diseases.

- Some physicians have decided to affiliate with an ACO, and participate in alternative payment models that would comply with the MACRA guidelines.

Pros: *greater reliance on standards and guidelines;

*routine and systematic interval measures of patient function and well-being, with disease-specific clinical outcomes;

*pooled clinical and outcome data, and

Cons: *Patient satisfaction.

*Physician satisfied quality health care is reduced in times of high patient number.

Dr. Doe's Proposed Strategy:

Option 1: Some physicians have decided to manage the quality data and reporting on their own.

Goal: Physician satisfaction of patient care with long time spent with patient to reduce high prescriptions and reduce time pressure.

Objectives:

-Reduce on call responsibilities in frequency

-decrease burdens of work load

-minimum private free time to reduce stress and demand of profession.

Measurement Criteria:

-Should not become a no claims physician

-Check for malpractice

-Length of patient visit

Barriers and constraints:

-Payment supported to be good enough to support all of the above plans in option A.

-Physician being pressurized to give high patient visits to earn more.

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