In CMS
Dec 28th, 2018
Will the latest regulations governing accountable care organizations (ACO) deliver favorable results for all? The Pathways to Success final rule, released by the Centers for Medicare & Medicaid Services (CMS) on Dec. 21, 2018, offers several new participation options and flexibility to healthcare organizations in the Medicare Shared Savings Program (MSSP). Participation options are meant ...
In Billing
Apr 3rd, 2018
Here’s a question to consider when coding and billing for services performed as part of an accountable care organization (ACO):  who pays providers’ standing claims if the ACO dies? If the State of Utah has its way, seven payers will have to pony up $26.6 million in unpaid claims for the Arches Health Plan, which folded ...
Feb 2nd, 2018
As employers predict average benefit costs to surpass $14,000 per employee, or a 5% increase, a study by the National Business Group on Health (NBGH) predicts growth in cost-saving access for employees and their families using telehealth, ACOs, and other means. Changes for Telehealth, ACOs, and More NBGH’s survey indicates employers are looking forward to ...
In CMS
Dec 22nd, 2017
2017 was a rough year. Hurricanes Harvey, Irma, and Maria battered parts of Florida and devastated Puerto Rico. Wildfires destroyed hundreds of thousands of acres in Northern California. And the Centers for Medicare & Medicaid Services (CMS) implemented a new payment system tied to improved health outcomes and reduced spending — two things that are impossible to control in ...
The Medicare Payment Advisory Commission’s (MedPAC) June Report to the Congress addresses (among other things) issues it sees with the Merit-based Incentive Payment System (MIPS) — one of two paths in the Centers for Medicare & Medicaid Services’ (CMS) Quality Payment Program, and a provision of the Medicare Access and CHIP Reauthorization Act (MACRA). “As ...