Category: Healthcare News

Reducing Reporting Burden

CMS Unveils New MIPS ‘Framework’ Aimed at Reducing Reporting Burden

The Trump administration has proposed updates to the Merit-based Incentive Payment System (MIPS) it says would ease the quality reporting burdens in the program. The Centers for Medicare & Medicaid Services (CMS) introduced a new framework for MIPS called MIPS Value Pathways (MVPs) with the goal of making it easier for physicians to participate in the program. Under […]
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CMS Proposes Updates for OPPS, Pitches Price Transparency Rules

CMS Proposes Updates for OPPS, Pitches Price Transparency Rules

The agency dropped proposals for three key payment programs aimed at cutting administrative burden and boosting price transparency. CMS has released three new proposed payment programs that aim to reduce administrative burden, put patients over paperwork, and increase price transparency for patients, the agency said in a statement emailed to journalists. Specifically, CMS has proposed […]
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Artificial Intelligence in RCM

How AI Can Create A Massive Competitive Advantage – 4 Financial Applications

Healthcare organizations have a tremendous opportunity to harness artificial intelligence in an area that may not seem flashy but is important nonetheless: revenue cycle management. Although 94 percent of companies firmly believe AI can give healthcare organizations a “massive competitive advantage,” according to Change Healthcare’s Adam Sullivan, PhD, less than 5 percent have extensively incorporated […]
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Surprise Billing Fight Escalates As Providers Win Arbitration Add To House Bill

Surprise Billing Fight Escalates As Providers Win Arbitration Add To House Bill

The House Energy and Commerce Committee passed the No Surprises Act with a provider-backed amendment adding an arbitration clause Wednesday afternoon. It will now head to the full House for consideration. Dive Brief: The House Energy and Commerce Committee is planning to add third-party arbitration to its surprise billing legislation, the No Surprises Act, on […]
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Effective And Profitable Chronic Care Management

How To Deliver Effective And Profitable Chronic Care Management

Chronic care management (CCM) has an overarching clinical goal—improving the health of Medicare patients with multiple chronic conditions. Besides knowing the service parameters, pay rates and usage requirements for CCM codes, physicians must understand how to effectively bill for CCM in order to profitably achieve that goal. Medicare pays for CCM (typically, non-face-to-face) services to […]
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MEDPAC Calls For End To ‘Incident To’ Billing

MEDPAC Calls For End To ‘Incident To’ Billing

“Incident to” billing by advanced practice registered nurses (APRNs) and physician assistants (PAs) would be eliminated if Congress adopts a recent recommendation from the Medicare Payment Advisory Commission (MedPAC). In its June quarterly report to Congress, MedPAC suggests requiring APRNs and PAs to bill Medicare payment directly for all their services, rather than under the national provider identifier […]
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Medicare Advantage And The Future Of Value-Based Care

Medicare Advantage And The Future Of Value-Based Care

The Medicare Advantage (MA) program, which allows Medicare beneficiaries to voluntarily enroll in a private plan that administers health benefits, was established by the Balanced Budget Act (BBA) of 1997 as a vehicle to bring private-sector competition and innovation to Medicare beneficiaries. When the program was announced, the goal was to create greater competition on […]
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Using Artificial Intelligence To Advance Revenue Cycle Management

Using Artificial Intelligence To Advance Revenue Cycle Management

Artificial intelligence (AI) is making big waves in healthcare from detecting lung cancer and gene mutations that lead to autism to addressing social determinants of health and chronic conditions. The technology is automating and optimizing clinical workflows, leading to improved outcomes, lower costs, and enhanced patient and provider satisfaction. The critical role artificial intelligence now plays in healthcare prompting some providers to […]
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electronic health record

Is Your EHR Ready For PDGM?

When the Patient-Driven Groupings Model (PDGM) launches Jan. 1, 2020, leveraging tools and resources to ensure compliance will be critical to a successful transition. Home health care providers already have one helpful tool in place: the electronic health record (EHR). By incorporating workflow efficiencies, alerts, customizable features and feedback reporting capabilities, EHRs can provide visibility […]
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