Health Policy
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Healthcare is a more dynamic market and now more than ever urgent care professionals need to stay informed on key issues affecting their patients' care. Be sure to stay up-to-date on health policy issues and the potential impact they may have on the urgent care industry by checking out the resources below.

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Medicare Proposed Fee Schedule Released: Urgent Care Specialty Measure Set Included & Big Changes for E&M (July 19, 2018): On July 12, the CY 2019 Medicare Physician Fee Schedule (PFS) proposed rule was released, which also includes proposed changes to the Quality Payment Program (QPP) for the 2019 performance year.  CMS is proposing a new urgent care specialty measure set.  The measure set, which includes 15 measures, was requested by the College of Urgent Care Medicine (CUCM) and Urgent Care Association (UCA).  Eleven of 12 measures proposed by CUCM and UCA were accepted. The creation of a measure set will serve to help urgent care providers with the selection of measures when fulfilling the quality component of the Merit-Based Incentive Payment System (MIPS).  The measure set also creates a distinction between family and emergency medicine.

Among the most consequential proposals in the rule is the creation a single payment amount for office/outpatient Evaluation and Management (E/M) visit levels 2 through 5. As a corollary to the proposed payment changes, CMS is proposing to apply a minimum documentation standard where, for the purposes of PFS payment for an office/outpatient E/M visit, practitioners would only need to meet documentation requirements currently associated with a level 2 visit for history, exam and/or Medical Decision Making (MDM) (except when using time to document the service). The proposed payment changes are budget neutral which will result in a redistribution of dollars among primary and specialty care.

Public comment on the proposed rule will be accepted until September 10.

Testimony by UCA to Reduce Health Care Costs (June 28, 2018): Reducing the cost of health care in the United States requires an understanding of health care cost drivers and empowering patients to make wise health care decisions. The Urgent Care Association (UCA) appreciates the opportunity to lend its voice to this discussions as all Americans should have access to affordable and comprehensive health care coverage. The reality is, however, that health care affordability requires attacking the cost drivers in our system without compromising access or quality. One cost driver is health system failure to incentivize site appropriate health care and the inability of consumers to make informed decisions on where to access care because transparency is lacking. Please read the testimony further here.

Value Based Reimbursement State by State: A 50-State Review of Value-Based Payment Innovation (June 21, 2018): The Payer Relations Committee discussed this item on a recent call and how it connects them with the Health and Public Policy Committee. This can serve as a valuable resource to UCA members as this report seeks to shed light on this other work through an examination of state-level value-based payment initiatives underway across America. Overall, five states stand out for the breadth of their initiatives, their embrace of payment models that involve shared risk, and their willingness to test innovative strategies. Please read the full report here.

UCAOA Offers Support on Pending MO Bone Marrow Bill (April 6, 2018)In a letter to members of the Missouri General Assembly, UCAOA offered support of the pending legislation that would encourage, but not require, primary care providers and urgent care physicians to inquire of new patients whether they are registered with the bone marrow registry. If a patient is not registered, the health care provider would provide information about the bone marrow registry. In its letter of support, UCAOA emphasized the importance of giving health care providers flexibility to voluntarily support initiatives to increase the number of potential bone marrow donors. The legislation has passed the Missouri House is now pending in the Senate. Send your thoughts, ideas and experiences to Nirja Shah at nshah@ucaoa.org.

Senators Solicit Views on Price Transparency; UCAOA Responds (April 3, 2018): Sens. Bill Cassidy, M.D. (R-LA), Michael Bennet (D-CO), Chuck Grassley (R-IA), Tom Carper (D-DE), Todd Young (R-IN), and Claire McCaskill (D-MO) are seeking feedback from the health care and patient communities as they develop legislation to improve price transparency in the health care market. In response to the solicitation, UCAOA submitted comments that the lack of price and information transparency is a contributor to hospital emergency department overuse. The Association also highlighted that many consumers dont know the difference on when to seek care at a free-standing emergency department versus an urgent care center and the associated costs a distinction that may not become apparently until after a patient received a bill for care provided in a free-standing emergency department that includes a facility charge. The Health & Public Policy Committee is interested in better understanding state-level price transparency requirements from an urgent care center perspective.  Send your thoughts, ideas and experiences to Nirja Shah at nshah@ucaoa.org.

UCA and CUCM Recommend Urgent Care Medicine Measure Set (February 15, 2018): On February 9, the Urgent Care Association (UCA) in collaboration with the College of Urgent Care Medicine (CUCM) submitted a letter to the Centers for Medicare and Medicaid Services (CMS) in response to a call for recommendations for specialty quality measure sets for the 2019 performance year of the Merit-Based Incentive Payment System (MIPS). If CMS agrees with UCA and CUCM and develops an urgent care medicine specialty set, it will help clinicians who practice in urgent care centers with the selection of applicable measures for fulfilling the quality component of MIPS. The specialty set recommended by the two societies includes 12 quality measures. However, clinicians choosing to report the urgent care medicine specialty measure set would only be obligated to report six measures, assuming the number of required measures does not change for the 2019 performance year. UCA will learn whether the urgent care medicine specialty measure set was accepted when the Quality Payment Program proposed rule is issued later this year.



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UCA State Resources: A listing of state specific resources and descriptions to help you reach out to local entities for further information.

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