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Inside Medicare's New Payment System-logo

Inside Medicare's New Payment System


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United States






Are We Prepared for MACRA and the Quality Payment Program? The Survey Says . . .

Host: Matt Birnholz, MD A recent survey of one thousand practicing physicians in the US, conducted by KPMG and the American Medical Association, is shedding new light on knowledge gaps in preparing for MACRA and the Quality Payment Program, and what can be done to address those gaps moving forward. Dr. Matt Birnholz speaks with Larry Kocot, Principal at KPMG and National Leader of the Center for Healthcare Regulatory Insight. Ross White, Manager for KPMG’s Center for Healthcare Regulatory...


“Pick Your Pace” Options Under the CMS Quality Payment Program

Host: Matt Birnholz, MD This discussion is dedicated to helping clinicians understand the “Pick Your Pace” option for Merit-Based Incentive Payment System (MIPS) participation.How should physicians navigate these new reporting options to avoid any payment penalties, and what are the most effective first steps? Host Dr. Matt Birnholz welcomes Dr. Kate Goodrich, Director of the Center for Clinical Standards and Quality under the Centers for Medicare and Medicaid Services. Dr. Goodrich also...


Questions on MACRA Everyone Wants to Know

Host: Matt Birnholz, MD MACRA’ is one of the hottest buzzwords in clinical medicine and health policy today. But in a fast-changing legislative landscape, questions arise on the current and future directions for MACRA, as well as best practices for all of us going forward. Host Dr. Matt Birnholz talks with AMA Washington Counsel, Ashley McGlone and Laura Hoffman, Assistant Director of Federal Affairs, about the top questions on MACRA that everyone wants to know.


What Are Physician-Focused Payment Models?

Host: Matt Birnholz, MD The new Quality Payment Program, QPP, created by Medicare Access and CHIP Reauthorization Act, or MACRA, has generated questions from the physician community regarding how to participate, and what that participation will mean for benefiting practices. On this episode, we’ll investigate physician-focused alternative payment models, or APMs, and their emerging role in this new Quality Payment Program. Host Dr. Matt Birnholz welcomes Sandy Marks, Assistant Director of...


What We Need to Know about Qualified Clinical Data Registries (QCDRs)

Host: Matt Birnholz, MD Qualified Clinical Data Registries, or QCDRs, are keys to Medicare’s new payment system in that they collect clinical data for the purpose of patient and disease tracking. But what do we need to know about QCDRs, where to find them, the requirements for successful reporting and why they are so important for clinical practices? Host Dr. Matt Birnholz welcomes a panel of QCDR experts from the AMA. Dr. Kathleen Blake, Vice-President, and Lance Mueller, Manager, both...


Preparing for Quality Reporting: Keys to Keeping Your Practice on Track

Ms. Koryn Rubin provides an overview of the reporting options under the Merit-Based Incentive Payment System (MIPS), specifically related to the quality performance category. After listening to this podcast, physicians should obtain a basic understanding between reporting as an individual or reporting as a group practice under MIPS. Ms. Rubin is Assistant Director of Federal Affairs at AMA. Program requirements are subject to change. The links below are intended to assist with MIPS...


How an EHR Can Help You Participate in MACRA

EHRs have made a significant impact in the practice of medicine across the country. While many improvements in the usability, flexibility, and interoperability of EHRs are needed, the use of an EHR can still be beneficial for many physicians. Matt Reid, MS provides you with information about the importance of electronic health records (EHRs) to participation in MACRA. Mr. Reid is a Senior Health Care IT Consultant at the AMA. You can find more information about certified EHRs at the Office...


Why Participating in Improvement Activities Matters

Under MACRA, most physicians will participate in a value-based payment program known as MIPS, which stands for Merit-based Incentive Payment System. Beginning with the 2019 physician fee schedule, MIPS will replace the Physician Quality Reporting System, Value-Based Modifier, and Meaningful Use of electronic health records programs. Ms. Laura Hoffman, Assistant Director in the Department of Federal Affairs at AMA, provides an overview of the Clinical Practice Improvement Activities, or...


APMs in Cancer Care: The Patient-Centered Oncology Payment Model

Host: Matt Birnholz, MD Guest: Robin Zon, MD, FACP Value-based, patient-centered care has become the destination for all branches of medicine, and is the philosophy driving modern payment reform initiatives like MACRA. But the unique care delivery needs in each specialty challenge the notion that one payment model can serve everyone. And nowhere has this become more relevant than in the field of oncology. Dr. Matt Birnholz joins Dr. Robin Zon, practicing oncologist and vice president and...


The Rise of Specialist-Driven Alternative Payment Models in American Medicine

Host: Matt Birnholz, MD Guest: Lawrence Kosinski, MD The advancement of the Medicare Access and CHIP Reauthorization Act (MACRA) has catapulted Alternative Payment Models into the spotlight for identifying new value-based approaches to care. But questions persist as to the roles that specialists can and should play in the design and implementation of APMs, how these models will cut healthcare costs, and which administrative partnerships are needed to make them successful. Dr. Lawrence...