Tag: RCM Services

CMS Releases Physician Fee Schedule Final Rule

CMS Releases Physician Fee Schedule Final Rule

  CMS says it the goal is to support health equity while focusing on high-quality person-centered care. Increased leverage of telehealth for behavioral care, diabetes prevention and mitigation, and enhanced payment for vaccine administration were three out of many priorities cited by federal officials who announced the release of the Centers for Medicare & Medicaid […]
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The Role of Provider-Sponsored Health Plans in Value-Based Care

The Role of Provider-Sponsored Health Plans in Value-Based Care

Provider-sponsored health plans can be naturally aligned with value-based care goals while also being attuned to providers’ needs. Providence Health Assurance’s Medicare Advantage provider-sponsored health plan received a five-star rating through the CMS Medicare Advantage Star Ratings system for the 2022 Medicare open enrollment season. The health plan, which serves Oregon and Washington State, is […]
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medicare-drops-end-stage-renal-disease-payment-rule-aims-to-close-health-equity-gaps

Medicare drops end-stage renal disease payment rule that aims to close health equity gaps

The Biden administration dropped a final rule Friday that will reward providers that improve rates of home dialysis and kidney transplants among low-income Medicare and dual-eligible beneficiaries. The goal of the changes is to encourage dialysis providers to decrease disparities in home dialysis and transplant rates, part of a larger effort by the Biden administration. […]
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2022 Medicare Advantage Plan Overview, Part Three_ Social Determinants

2022 Medicare Advantage Plan Overview, Part Three: Social Determinants

  “Medicare Advantage plans have a unique and growing opportunity to address the needs of socioeconomically vulnerable populations and improve their health,” reports America’s Health Insurance Plans. More plans for individuals with low incomes, as well as targeted SDOH investments and initiatives, round out carrier approaches. On the benefits side, offerings such as meals, transportation, […]
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More Medicare Advantage plans will offer nonmedical benefits in 2022, finds Avalere

More Medicare Advantage plans will offer nonmedical benefits in 2022, finds Avalere

  More plans will offer meals, nutrition, transportation or in-home support services at a $0 premium in 2022. Ahead of the annual election period, which began on October 15, the Centers for Medicare and Medicaid Services published information on MA and Part D plan (PDP) premiums, benefit offerings and star ratings. Avalere analyzed that data […]
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Key Characteristics for Successful Downside Risk Contracting

Key Characteristics for Successful Downside Risk Contracting

Organizations that do strong vendor relationships, invest in the organization, and are willing to take on commercial risk will be poised to take on downside risk financial contracts. Through working with population health management vendors, KLAS released a recent report identifying which of their customers are most advanced in adopting downside risk contracts. In the […]
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The Leaders Say Efficiency, Not Finances, Is Top Rev Cycle Rpa_ai Benefit

The Leaders Say Efficiency, Not Finances, Is Top Rev Cycle Rpa/ai Benefit

More than 80% of leading health systems that are using RPA/AI say their primary reason for investing in the technology was improving financial performance, but once the technology was in use, they said efficiency was the top benefit. The reasons that leading health systems initially invest in robotic process automation (RPA) and artificial intelligence (AI) […]
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