A 7 percent payment update in your professional claims is at stake. That’s a nice bonus on top of the automatic 0.5 percent update to the Physician Fee Schedule (PFS). This is the last year for the automatic update, however. The only shot clinicians have at a PFS payment update in 2020 and beyond is ...
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 understanding each other’s role in healthcare reimbursement, coders and CDI specialists make a dynamic duo. In healthcare, we can no longer work in silos, separate from each other, doing our own thing, unaware of what other staffers are doing. We must work collaboratively, as a team that extends past our own departments. Value-based healthcare ...
Act now to score positive payment adjustments under MIPS. This year, the Cost performance category in the Merit-based Incentive Program (MIPS) is worth 10 percent of an eligible clinician’s or group’s final score. Next year, it goes up to 15 percent — and Cost will continue to gain weight until it accounts for 30 percent ...
The Centers for Medicare and Medicaid Services (CMS) released a Final Rule freeing more than $10.4 billion to anxious payers to continue the Affordable Care Act’s (ACA) risk adjustment program. The agency had halted payments to payers while a New Mexico ruling was challenged, but in the end the activity unnerved the industry and didn’t change much. Risk Adjustment ...