RESUMO
A central approach to achieving high-quality neurologic care is to reduce the burden on providers in accessing services needed to achieve this level of care. Neurology-based practices across the continuum (solo, multispecialty, hospital, or health system-based) have adopted different methods to mitigate the impact of gatekeeper methods of prior authorization and related mechanisms. We discuss ways to partner with payers through innovative Gold Carding programs that reduce the burden of gatekeeper mechanisms on neurology providers, thereby allowing them to consistently focus their efforts in the provision of high-quality neurologic care.
RESUMO
The American Academy of Neurology (AAN) has recently proposed 3 outcome metrics crafted to be both broadly applicable across neurologic diseases and to function as potential tools to facilitate quality improvement. These measures should be of interest to physicians and payers due to the increasing linkage of reimbursement to quality care. However, the use of quality measures cannot exist in a vacuum as external factors outside of physician control can negatively affect these metrics. The original Centers for Medicare and Medicaid (CMS) value-based programs illustrate the necessity for iterative review and revision of outcome metrics to allow for risk adjustment to avoid unjust penalties. Accordingly, at this time, the Neurology Outcome Measurement Set is not suitable for inclusion in a quality payment program.
