Healthcare News
As of early October, the Centers for Medicare & Medicaid Services (CMS) began to implement the Bundled Payments for Care Improvement - Advanced Model. This model builds upon the BPCI that ended on September 30th, and will run until the end of 2023.
Running an orthopedic practice means that you must always be aware of changes to coding and policy in the industry, so that the information you submit and care you provide is up to date, accurate, and abides by all necessary rules and regulations.
In recent months, CMS issued the 2018 Hospital Outpatient Prospective Payment System (OPPS) and Ambulatory Surgical Center (ASC) final rule. This, in effect, changes the rates and quality provisions for 2018.
What are QPP Tools? QPP stands for Quality Payment Program. The Quality Payment Program was designed to improve Medicare by helping physicians focus on the quality of care over service volume. Prior to 2015, physicians were reimbursed on a fee-for-service model. In 2015, QPP was introduced, bringing a two track value-based reimbursement system to replace […]
What is the CMS Medicaid Integrity Strategy? The Centers for Medicare & Medicaid Services (CMS) developed the Medicaid Integrity Strategy to combat abuse, fraud, and the waste of Medicaid dollars. The Medicaid Integrity Program was the first comprehensive Federal strategy aimed at combating the abuse of the Medicaid program. This program aims to keep Medicaid […]
The lifeblood of your orthopedic practice exists in how well your revenue is managed. Accuracy means everything and it’s essential to your bottom line. There’s no better solution than keeping your internal operations of your practice at peak efficiency and having employees well versed in the industry’s orthopedic billing codes.
Payor Reform Opportunities for Spine Surgery A recent article published in Clinical Spine Surgery observed payor reform opportunities for spine surgery. The article, written by Jason Scalise, MD, and David Jacofsky, MD, focuses on bundled payments, and the demands for spine surgery to implement bundled payment strategies. Spine procedures are projected to increase dramatically due […]
CMS Proposed Cuts to Mammography Reimbursements Due to be released in early July, the CMS will likely propose a 50 percent cut to the technical component of mammography reimbursement in the 2018 Medicare Physician Fee Schedule (MPFS) proposed rule. According to industry experts, cutting down mammography reimbursements could potentially drive down access to a […]
In April 2017, the federal government finalized its 2018 payment rates for Medicare Advantage (MA) plans, settling on an average rate increase of 0.45% after originally suggesting a 0.25% increase.
On March 3rd, the Medicare Payment Advisory Commission (MedPAC) discussed proposed reforms to the Merit-Based Incentive Payment System (MIPS) and Advanced Alternative Payments Models (A-APMs). The purpose of this meeting was to review the issues and challenges facing the Medicare program and then making policy recommendations to Congress. Commissioners suggested different ways to help physicians’ […]
This content was originally posted on Jan. 22, 2016 by Katherine Moody on FierceHealthPayer. Click here to see the original source.
By now, you and your staff are probably quite familiar with the concepts and regulations of “meaningful use” (MU) of electronic health record (EHR) technology which has to be demonstrated in order for hospitals and eligible providers (EPs) to receive the incentive payments from the Centers for Medicare and Medicaid Services (CMS). You are probably also fully […]