Tag: Medicare Beneficiaries

CMS Improves Outcomes & Reduces Costs with Specialty Care

Specialty care improves outcomes and reduces costs for CMS

Streamlining Specialty Care: CMS’s Innovation Center prioritizes strategies that improve personalized healthcare information, implement financial services, and support segment-based classifications. A value-based approach to care must address underlying issues and individualized care to reduce patient outcomes. CMS’s innovation strategy describes ongoing efforts to integrate personalized care into the healthcare system. Previous studies have shown that […]
Learn More
Medicare Conversion Factor

Medicare Conversion Factor Increases, But Payments Remain Lower

Medicare Conversion factor are up but payouts are still down compared to last year. Healthcare professionals will see a slight upward adjustment to their Medicare payments starting March 9 after President Biden signs the Consolidated Appropriations Act (CAA), 2024.  Really fortunately, although the 2024 CAA increases the conversion factor (CF) finalized for calendar year (CY) […]
Learn More
Medicaid payment model

CMS Unveils Medicaid Payment Model for Improved Behavioral Health

CMS’s Medicaid Payment Model show can be seen as a healthcare bridge, giving fundamental behavioral wellbeing administrations to both Medicaid and Medicare beneficiaries over a period of eight years. As portion of a unused Medicaid Payment Model demonstrate reported by CMS, physical, behavioral, and community suppliers will be required to arrange care in arrange to […]
Learn More

CMS Enhanced Patient Appeal Procedures

Doctors must consider the implications of altering a patient’s status. The Centers for Medicare & Medicaid Services (CMS) is suggesting novel retrospective and prospective appeal procedures in compliance with a federal district court order from the District of Connecticut. On December 21, the agency unveiled a proposed rule aiming to institute an appeal mechanism for […]
Learn More

How Implementing Site-Neutral Policies Can Help Reduce Healthcare Costs

The United States grapples with a healthcare affordability crisis, anticipating a 6.5 percent surge in costs due to inflation next year. Amidst concerns over escalating medical expenses, the deeper roots of these inflated prices often evade attention. Deficient government policies, notably Medicare reimbursement policies, contribute to consolidating the healthcare sector, ultimately driving up costs that […]
Learn More

CPT® codes play a pivotal role in the transition to value-based care

In order for value-based healthcare to succeed, it is imperative that physician practices effectively articulate the medical services and procedures they provide. This underscores the vital role of the Current Procedural Terminology (CPT®) code set in driving the shift towards value-based care. According to the chair of the AMA/Specialty Society Relative Value Scale Update Committee (RUC), […]
Learn More

Medicare Advantage Plans: A Positive Experience for Beneficiaries

Higher satisfaction with problem resolution was observed among beneficiaries who were more inclined to renew their Medicare Advantage plan. Medicare Advantage plans have garnered favorable satisfaction scores, with beneficiaries showing high approval ratings for trustworthiness, operational ease, and coverage adequacy, as outlined in a recent market research study. The 2023 US Medicare Advantage Study encompasses […]
Learn More

CMS Announces Proposed Medicare Payment Reduction of 3.4%

The 2024 Medicare Physician Fee Schedule proposal includes a reduction of 3.4% to the conversion factor that determines Medicare payment rates. This reduction will widen the gap between practice expenses and reimbursement. If the proposal is approved, the new conversion rate will be $32.7476. Here are some other key highlights of the CMS proposal: The […]
Learn More