Posts Tagged ‘physician reimbursement’

Infographic: The Impact of a Changing Reimbursement Landscape

June 18th, 2018 by Melanie Matthews

Most healthcare providers revealed that they wouldn’t drop a contract with a payer even if they knew they were underpaid, according to a new infographic by BillingParadise.

The infographic details recent trends in the reimbursement climate and industry changes that are having an impact on how providers are reimbursed.

Medicare Chronic Care Management Billing: Evidence-Based Workflows to Maximize CCM RevenueSince the January 2015 rollout by CMS of new chronic care management (CCM) codes, many physician practices have been slow to engage in CCM.

Arcturus Healthcare, however, rapidly grasped the potential of CCM to improve patient outcomes while generating care coordination revenue, estimating it could earn up to $100,000 monthly for qualified patients treated in its four physician practices—or $1 million a year.

Medicare Chronic Care Management Billing: Evidence-Based Workflows to Maximize CCM Revenue traces the incorporation of CCM into Arcturus Healthcare’s existing care management efforts for high-risk patients, as well as the bonus that resulted from CCM code adoption: increased engagement and improved relationships with CCM patients.

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Infographic: Healthcare Payment Model Reform

November 3rd, 2017 by Melanie Matthews

As the 79 million baby boomers turn 65, they will grow the
Medicare-eligible cohort from 13.1 percent to 20.3 percent in 2030, according to a new infographic by HORNE Healthcare.

The infographic provides advice for providers to prepare for success in the ever-changing healthcare reimbursement environment.

Under CMS’s “Pick Your Pace” choices for Year 1 Quality Payment Program participation, physician practices may opt for the minimum activity necessary to avoid a payment penalty in 2019 by simply submitting some data in 2017.

However, instead of delaying MACRA participation to the later part of this year, physicians should prepare and better position themselves today for MIPS success by analyzing their existing CMS data on their practices’ performance and laying a path now toward performance improvement.

Physician MACRA-Readiness: Mining QRUR and Other CMS Data to Maximize MIPS Performance describes the wealth of data analytics available from the CMS Enterprise Portal–Quality Resource Use Reports (QRURs) and other reports providing a window into practice performance under the Merit-Based Incentive Payment System (MIPS). MIPS is one of two MACRA reimbursement paths and the one where most physician practices are expected to align.

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Infographic: Banking the Upside from Value-Based Reimbursement

October 11th, 2017 by Melanie Matthews

As healthcare reimbursement shifts toward paying for value, there’s significant revenue at stake for physician practices, according to a new infographic by athenahealth, Inc.

The infographic examines five different types of physician practices and how participation in value-based reimbursement models would impact practice revenue.

No matter which level of participation physician practices choose for the first Quality Payment Program performance period beginning January 1, 2017, CMS’s “Pick Your Pace” announcement means practices should proactively prepare for the impact of the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) on physician quality reporting and reimbursement.

MACRA Physician Quality Reporting: Positioning Your Practice for the MIPS Merit-Based Incentive Payment System delivers a veritable MACRA toolkit for physician practices, with dozens of tips and strategies that lay the groundwork for reimbursement under Medicare’s Merit-based Incentive Payment System (MIPS), expected to begin in 2017 and one of two payment paths Medicare will offer to practices.

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Infographic: Preparing for MACRA

April 21st, 2017 by Melanie Matthews

Only 35 percent of health systems have a MACRA strategy and are going to be ready to participate, according to a new infographic by Health Catalyst.

The infographic examines the top MACRA concern, preparation levels and potential benefits.

Under CMS’s “Pick Your Pace” choices for Year 1 Quality Payment Program participation, physician practices may opt for the minimum activity necessary to avoid a payment penalty in 2019 by simply submitting some data in 2017.

However, instead of delaying MACRA participation to the later part of this year, physicians should prepare and better position themselves today for MIPS success by analyzing their existing CMS data on their practices’ performance and laying a path now toward performance improvement.

Physician MACRA-Readiness: Mining QRUR and Other CMS Data to Maximize MIPS Performance describes the wealth of data analytics available from the CMS Enterprise Portal–Quality Resource Use Reports (QRURs) and other reports providing a window into practice performance under the Merit-Based Incentive Payment System (MIPS). MIPS is one of two MACRA reimbursement paths and the one where most physician practices are expected to align.

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Infographic: MACRA Pathways

November 16th, 2016 by Melanie Matthews

Under MACRA, 2017 will be the first performance year physicians will be scored to determine payment adjustments in 2019. Physicians will choose between two payment tracks: the Merit-based Incentive Payment System (MIPS) or the Alternative Payment Model (APM), according to a new infographic by the American Academy of Family Physicians (AAFP).

The infographic highlights the path options physicians can choose.

Infographic: MACRA Pathways

No matter which level of participation physician practices choose for the first Quality Payment Program performance period beginning January 1, 2017, CMS’s “Pick Your Pace” announcement means practices should proactively prepare for the impact of the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) on physician quality reporting and reimbursement.

MACRA Physician Quality Reporting: Positioning Your Practice for the MIPS Merit-Based Incentive Payment System delivers a veritable MACRA toolkit for physician practices, with dozens of tips and strategies that lay the groundwork for reimbursement under Medicare’s Merit-based Incentive Payment System (MIPS), expected to begin in 2017 and one of two payment paths Medicare will offer to practices.

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Infographic: 10 Things To Know About MACRA

October 3rd, 2016 by Melanie Matthews

The Medicare Access and CHIP Reauthorization Act provides a new framework for the drive toward value-based reimbursement for physicians, according to a new infographic by athenahealth Inc.

The infographic provides physicians with 10 critical steps to prepare for MACRA.

No matter which level of participation physician practices choose for the first Quality Payment Program performance period beginning January 1, 2017, CMS’s “Pick Your Pace” announcement means practices should proactively prepare for the impact of the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) on physician quality reporting and reimbursement.

MACRA Physician Quality Reporting: Positioning Your Practice for the MIPS Merit-Based Incentive Payment System delivers a veritable MACRA toolkit for physician practices, with dozens of tips and strategies that lay the groundwork for reimbursement under Medicare’s Merit-based Incentive Payment System (MIPS), expected to begin in 2017 and one of two payment paths Medicare will offer to practices.

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Infographic: Are You Ready to Add Recurring Revenue to Your Physician Practice?

July 20th, 2016 by Melanie Matthews

Some 68 percent of the Medicare population have two or more chronic conditions, according to a new infographic by CareSync.

The infographic examines how physician practices can bill for chronic care management (CCM) services under CMS’ CCM program and the impact of CCM on outcomes and the patient experience.

Chronic Care Management Reimbursement Compliance: Physician Requirements for Value-Based RevenueBeyond providing added revenue, billing via Medicare Chronic Care Management (CCM) CPT codes helps to bridge physician practices to value-based care delivery models like the accountable care organization (ACO) or patient-centered medical home (PCMH). Use of the CCM codes is also an opportunity to launch or enhance a chronic care management program. According to 2015 market data, nearly half of responding healthcare organizations lack a formal chronic care management structure, leaving critical reimbursement dollars on the table.

However, practices poised to bill under CCM codes must contend with vague guidance from CMS in certain areas and conflicting interpretations from outside sources on CCM implementation.

Chronic Care Management Reimbursement Compliance: Physician Requirements for Value-Based Revenue sets the record straight on CCM reimbursement compliance, offering strategies for navigating obstacles and meeting requirements.

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Infographic: Provider Risk Readiness

June 8th, 2016 by Melanie Matthews

The Medicare Access and CHIP Reauthorization Act (MACRA) dramatically changes Medicare physician reimbursement.

A new infographic by AMGA examines the MACRA timetable, groups affected, tools that physician groups will need for effective implementation and the biggest impediment to physician groups taking on downside risk.

With the nation’s leading accountable care organizations already testing the waters with CMS’ newest value-based reimbursement opportunity, the Next Generation Accountable Care Organization Model, healthcare organizations are evaluating how this new opportunity aligns with their value-based contracting strategy.

During Next Generation ACO: An Organizational Readiness Assessment, a 60-minute webinar on April 5, 2016, now available for replay, Healthcare Strategy Group’s Travis Ansel, senior manager of strategic services, and Walter Hankwitz, senior accountable care advisor, will provide a value-based, risk contract roadmap to determine organizational readiness for participation in the Next Generation ACO Model in particular and in risk-based contracts in general.

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Infographic: MACRA Countdown to Measurement Year Goals

May 27th, 2016 by Melanie Matthews

Under MACRA, the physician quality measurement systems in place in 2017 will determine physician Medicare reimbursement in 2019, according to a new infographic by Geneia.

The infographic describes the pace of change in physician value-based reimbursement, the adjustments that will be made to Medicare claims starting in 2019 and three steps that practices should be taking now to be ready.

Since the January 2015 rollout by CMS of new chronic care management (CCM) codes, many physician practices have been slow to engage in CCM. Arcturus Healthcare, however, rapidly grasped the potential of CCM to improve patient outcomes while generating care coordination revenue, estimating it could earn up to $100,000 monthly for qualified patients treated in its four physician practices—or $1 million a year.

Medicare Chronic Care Management Billing: Evidence-Based Workflows to Maximize CCM Revenue traces the incorporation of CCM into Arcturus Healthcare’s existing care management efforts for high-risk patients, as well as the bonus that resulted from CCM code adoption: increased engagement and improved relationships with CCM patients.

Get the latest healthcare infographics delivered to your e-inbox with Eye on Infographics, a bi-weekly, e-newsletter digest of visual healthcare data. Click here to sign up today.

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Infographic: Chronic Care Management Revenue Opportunities

December 9th, 2015 by Melanie Matthews

The value of gaining experience and proficiency with population management and value-based reimbursement is becoming essential as Medicare shifts a greater portion of its payments to these methodologies. Medicare’s chronic care management reimbursement codes allow practices to get paid while learning about this new shift and gaining confidence and competence with value-based reimbursement, according to a new infographic by McKesson.

The infographic examines the incidence of chronic conditions among Medicare beneficiaries and the revenue opportunity for practices that bill Medicare under the Chronic Care Management codes.

Starting this past January, Medicare is reimbursing physician practices for select Chronic Care Management (CCM) services not previously eligible for reimbursement, underscoring the vital role of care management in primary care.

Physician Reimbursement for Chronic Care Management: Identifying New Practice Revenue Opportunities offers practical guidance to prepare physician practices to maximize CCM reimbursement in the year ahead.

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