Healthcare Business Monthly
The Latest Facts on Advancing Care Information Performance Category

January 1, 2017, marked the start of the first performance year for the Merit-based Incentive Payment System (MIPS). And yet, the Centers for Medicare & Medicaid Services (CMS) is still working out the details for this new quality incentive program. The agency released on December 29, 2016, a Fact Sheet regarding the Advancing Care Information (ACI) performance category. Although it is mostly a rehash of previously-released information, this new guidance reveals important details.

CMS Expands Advanced APM Choices

The Centers for Medicare & Medicaid Services (CMS) announced Dec. 20 several new Innovation Center models and an update to the Comprehensive Care for Joint Replacement Model. The new payment models will allow for a broader range of clinicians to qualify for a 5 percent incentive payment through the Advanced Alternative Payment Model (APM) track of the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) and the Quality Payment Program.

The Importance of Patient Registration

Complete and accuruate patient registration is crucial to a medical practice’s bottom line. Because circumstances and policies change often, staff should confirm and update patient demographics and insurance information at each visit. How you do this is also important: Rather than rely on “yes” or “no” answers from the patient, ask open-ended questions that require a full response, and therefore ensure you’re getting the most up-to-date information.

CMS Releases Proposed IPPS/LTCH Rules for 2017

The Centers for Medicare & Medicaid Services (CMS) issued a proposed rule to update fiscal year (FY) 2017 Medicare payment policies and rates under the Inpatient Prospective Payment System (IPPS) and the Long-Term Care Hospital (LTCH) Prospective Payment System (PPS). The proposed rule, which CMS says would apply to approximately 3,330 acute care hospitals and approximately 430 LTCHs, would affect discharges occurring on or after October 1, 2016.

CMS Finalizes Standards for Issuers and Health Insurance Marketplaces
The Centers for Medicare & Medicaid Services (CMS) is creating a next generation risk adjustment model that will: (1) account for the number of individuals who had a Marketplace plan for less than 12 months; (2) better account for the risk of high-cost patients; (3) improve compensation for healthier members; and (4) use prescription drug data as another way to account for sicker members.
Cost of Using Non-standard CT Scanners Goes Up in 2017

In accordance with Protecting Access to Medicare Act of 2014 (PAMA), and to promote patient safety and public health, the Centers for Medicare & Medicaid Services (CMS) created modifier CT Computed tomography services furnished using equipment that does not meet each of the attributes of the National Electrical Manufacturers Association (NEMA) XR-29-2013 standard) to discourage use of non-standard radiology equipment.

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