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Finding New Vistas in Health Care

A couple of weeks ago, I was talking with a neighbor who had just completed a 100-mile race across the Bonneville Salt Flats in Utah. He is an adventurer who loves river running, skiing and most any outdoor activity. I enjoy hiking, so we often talk about different trails in Utah. I've lived in Salt Lake City most of my life and feel I'm pretty knowledgeable about local treks, until he told me about the Heughs Canyon waterfall. I had never heard of this waterfall and was intrigued since the trailhead was less than 10 minutes away from my neighborhood.

My wife and I hiked to this beautiful waterfall last weekend and were surprised to find a cave, lean-to and fun bridges on the trail. As I was returning from the hike, I was reminded of the knowledge (and adventures) right under our noses that we often overlook because we don't know where to find them. I was grateful for a friend who pushes beyond the status quo and finds new adventures in the outdoors.

In health care, we are constantly pushing beyond the limits and looking for transformation and innovation to propel our health care system to heights never seen before. Currently, payment reform is big focus. Medicare is taking a leading role with bipartisan support behind the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) legislation and is beginning to roll out the Quality Payment Program (QPP). There is a lot of information and resources about payment reform and QPP that clinicians may not know are available.

The Centers for Medicare & Medicaid Services (CMS) has created an informative website ( that is easy to navigate and provides information about QPP. CMS regularly adds new features including, most recently, an eligibility tool through which clinicians can determine their eligibility with their NPI number. There is also a QPP Service Center that can be accessed at 1-866-288-8292. In addition, CMS is attending national conferences to promote the QPP program and is offering many places to receive additional support. HealthInsight is one of these places. We have QPP experts ready to support providers in this transformation. We also have a website with QPP information and resources. Although we don't have contract funds to do reporting for clinicians, we can help practices understand and successfully navigate QPP. We are here to answer questions and offer no-cost technical assistance and strategies to ensure success in QPP.

QPP is for clinicians in the outpatient setting, but payment reform is well on its way in other health care settings. Other private payers are following Medicare's lead and have begun to roll out their own versions of quality payment reform.

As with any transformation, we can expect occasional obstacles on the trail. If we can keep the goals of higher quality, smarter spending and patient centered care in the forefront, we will work through the challenge, and like my adventurer friend with waterfalls, we will see vistas in health care we never knew were there.

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