Integrating primary care and behavioral healthcare can shore up the nation’s capacity to address the surging mental health crisis, according to a new report. Existing value-based payment structures can be deployed to promote the availability of high-quality behavioral healthcare.
Although reduced reimbursement for acromioplasty has negatively impacted me financially, it has not impacted my patients. I still use the patient’s clinical history, symptoms and surgical findings to perform acromioplasty when I consider it to be helpful based on evidence-based medicine, logic and my experience. In 2012, code 29826 was changed to an add-on code and was reduced from 9.16 relative value units (RVUs) to 3 RVUS. That reduction in reimbursement had a moderate negative financial impact on my practice for Medicare patients.
Delays in adopting new current procedural terminology codes cost one academic radiology practice hundreds of thousands of dollars in revenue, according to a new analysis.
Despite efforts to educate clinicians and increase payment revisions, little has changed in the amount spent on low-value healthcare for traditional fee-for-service Medicare patients.
Understanding all that’s required to secure healthcare payment during a pandemic — especially for services related to COVID-19 — demanded that revenue cycle teams quickly refine denials management processes to protect their organization’s financial health. It also necessitated a spirit of patience and understanding toward payers, which faced a similar learning curve.
Published literature has shown the postponement and cancellation of elective procedures during the COVID-19 pandemic had a substantial financial impact on orthopedic practices and hospitals. In a study in International Orthopaedics, Matthew J. Best, MD, and colleagues estimated hospital losses of $10.9 to $11.9 billion in reimbursement and $2.6 to $3.5 billion in net income due to canceled elective musculoskeletal surgery during 8 weeks of the COVID-19 pandemic.
The Centers for Medicare and Medicaid Services dropped its hotly anticipated final Physician Fee Schedule on Tuesday that includes significant compensation cuts for radiologists and other specialties.
CMS has issued a final rule on the Medicare physician self-referral law (Stark Law) and anti-kickback rules that better integrate value-based care, and lessens regulatory burdens on physicians.
The COVID-19 pandemic has complicated the efforts of hospitals and health systems to succeed under risk-based payment models, but that hasn’t dampened some organizations’ pushes to increase their revenue from value-based payment (VBP). In response to the pandemic’s disruption in care for patients in VBP models, Medicare has offered providers wide latitude to help them avoid financial consequences during 2020.
As healthcare payment liability continues to shift to patients, it has become increasingly important for healthcare organizations to offer convenient and accessible patient payment options. Prior to COVID-19, the exponential growth of high deductible health plans along with rising consumerism drove the need for more flexible payment vehicles. While those drivers are still valid, the current public health crisis has made payment programs even more essential.
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