Category: Revenue Cycle Management

Home Dialysis Medicare Payment

CMS Finalizes Payment Model Aimed At Boosting Access to Home Dialysis, Kidney Transplants

The Trump administration has finalized a rule aimed at boosting access to home dialysis and translation for patients with end-stage renal disease. The Centers for Medicare & Medicaid Services estimates that the End-Stage Renal Disease Treatment Choices Model will save Medicare $23 million over the next five years. The value-based model is designed to incentivize providers to […]
Patient Collection Tips

Nine Tips for Collecting Patient Balances

Practices have been creative during COVID-19 to ensure safe patient access: Telephone visits. Curbside immunizations. Drive-up virus testing. Even checking patients in for their in-office visits while they wait in the car. However, each of these scenarios poses one significant challenge: Collecting copayments and coinsurance. “With COVID-19, you’ve got to find ways to meaningfully engage […]
Medicare MIPS

MIPS Proving a Financial Boon for System-Affiliated Doctors

Doctors looking to earn more under Medicare’s Merit-based Incentive Payment System (MIPS) would likely benefit from working in a practice affiliated with a hospital system. A recently-published study in JAMA finds that doctors in system-affiliated practices earned substantially higher MIPS scores in 2019 than those in independent practice, and were thus more likely to receive upward payment adjustments and […]
Clinicians Disadvantages under MIPS

Clinicians Serving Socially At-Risk at a Disadvantage Under MIPS

  Clinicians who served more patients with social risk factors such as low income performed worse in the Merit-Based Incentive Payment System’s inaugural payment year, and therefore, received unfavorable value-based reimbursement, according to a new study. The study recently published in Health Affairs found that out of 510,020 clinicians participating in the Merit-Based Incentive Payment System (MIPS) in […]
Telehealth Reimbursement

Telehealth Reimbursement Just for Value-Based Providers Post-COVID?

Telehealth reimbursement expansions granted during the PHE may be limited to providers in Advanced APMs moving forward to prevent program integrity issues, MedPAC said at a recent meeting. The Medicare Payment Advisory Commission (MedPAC) is the latest group to weigh telehealth reimbursement expansions after the COVID-19 pandemic. In a meeting held virtually last week, MedPAC analysts Ariel […]
Telehealth RCM

Maximizing Telehealth Success: How to Optimize Operations & Revenue Cycle Management

  In COVID-19’s wake, providers’ financial recovery will be crucial yet daunting. U.S. hospitals and health systems stand to collectively lose $36.6 billion between March and June 2020 alone. Physician practices also face serious financial challenges as they recoup revenues that declined up to 55 percent and patient volume that decreased 60 percent. Amid these hardships, telehealth has emerged as […]
Revenue Cycle Management in Radiology Practices

After COVID-19, Radiology to Rethink Revenue Cycle Management

More Medicaid and self-pay patients, fewer radiologists, and a greater need for efficiency should prompt radiology practices to optimize revenue cycle management. Declining volumes and revenues during the COVID-19 pandemic could spell big trouble for many radiology practices unless the providers refocus revenue cycle management efficiency and effectiveness for a post-pandemic world. The COVID-19 pandemic […]