Articles related to Medicare

CMS recently updated regulations for Programs for All-Inclusive Care for the Elderly (PACE) to strengthen protections for participants and allow more operational flexibility for providers.

"I hate to say it, but anything is better than nothing. We're getting slaughtered," says David McCormack, about the potential hospital wage index (area wage index - AWI) increase in Medicare reimbursements.

The government's 340B drug discount program, which was begun in 1992, has been under the scrutiny of the Administration and Congress for the past two years with ill effects for participating hospitals and the potential for more reform on the horizon.

"The one thing doctors should be doing is making sure their patients have their address correct with Medicare," says Phillip Allen, billing service manager with MediSYS.

As families gather the generations together for the holidays, it's a good time to reflect on the health status of the community's most senior members.

PACE programs take a holistic approach to senior care within the continuum to craft individualized plans that allow older adults to thrive within their own community.

"The new changes in the 2018 reporting period are actually not terribly drastic," says Joni Wyatt, MHA, MHIA, CPHIMS, FHIMSS, with Kassouf & Co about the Merit-based Incentive Payment System (MIPS).

On Sept. 8, 2016 the final rule Emergency Preparedness Requirements for Medicare and Medicaid Participating Providers and Suppliers was published in the Federal Register. By Nov. 16, 2017, providers and suppliers must be in compliance.

With the 2017 reporting window rapidly closing, a recent AMA/KPMG survey finds less than 25 percent of physician decision-makers feels 'well prepared' to meet requirements.

Starting in 2019, Medicare's push toward value-based reimbursements will be within reach of the finish line. "It can sound terrifying," says Joni Wyatt, MHA, MHIA, CPHIMS, FHIMSS with Kassouf & Co. "But most practices have already done the work."

On September 8^th, Medicare announced two more ways to participate in the upcoming shift to the Medicare Access and CHIP Reauthorization Act (MACRA). "There are four different payment programs now, since the release of the pick-you-pace model," says Carrie Gulledge, RHIA, director of EHR with MediSys. "They allow providers to test the waters with their toe or jump all in."

With just two Medicare exam codes, a physician raised her revenue by $45,320. “So many services that patients are eligible for, like preventative care visits, don’t get utilized by providers, and many are already performing the services,” says Julie Thompson, billing supervisor at MediSYS.

Two tracks for Shared Savings Accountable Care Organizations

The final regulations governing Medicare accountable care organizations were released by the Centers for Medicare and Medicaid Services in October, and they represent a sea change in healthcare’s future...