Tag: Alternative Payment Models

amga-to-cms-rethink-aco-financial-risk-advancement-in-mssp

Rethink ACO Financial Risk Advancement in MSSP

AMGA expressed some concerns following CMS’ decision to extend its postponement policy regarding ACO financial risk advancement in the Medicare Shared Savings Program. The American Medical Group Association (AMGA) recommended several steps regarding accountable care organization (ACO) financial risk advancement in the Medicare Shared Savings Program (MSSP) in a letter to CMS. CMS’ decision to […]
2021 Medicare Physician Fee Schedule Rule

Top 3 Concerns with the 2021 Medicare Physician Fee Schedule Rule

Comments on the 2021 Medicare Physician Fee Schedule proposed rule centered on potential payment cuts, telehealth reimbursement, and quality reporting changes. Provider groups are concerned that some proposals in the Medicare Physician Fee Schedule rule for 2021 would exacerbate the financial challenges physicians are already facing during the COVID-19 pandemic, including lack of adequate telehealth […]
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 […]
Telemedicine Reimbursemnt

Beyond the Pandemic: Telemedicine Reimbursement and Health Policy

Telemedicine reimbursement and other regulatory flexibilities enabled providers to quickly pivot operations for COVID-19, but temporary policies also poised the health policy landscape for significant change after the pandemic. In the wake of the first confirmed cases of COVID-19 in the US, policymakers quickly relaxed long-standing healthcare regulations, including telemedicine reimbursement and healthcare fraud prevention […]
Physician Fee Schedule

CMS Proposes Changes to Physician Fee Schedule, Quality Payment Program

The Centers for Medicare & Medicaid Services (CMS) is proposing changes to the Medicare Physician Fee Schedule (PFS) and the Quality Payment Program as part of its effort to reduce provider burden. “Clinicians are drowning in paperwork and reporting requirements caused by cumbersome government rules and regulations,” said CMS Administrator Seema Verma in a press […]

Four Ways RCM Must Transform for the Shift to Value-Based RCM

Value-based care is driving transformation of many established operations within medical groups—and the revenue cycle is no different. It is likely that 2018 will be remembered as the year that value-based care became a financial reality for most U.S. medical practices. Those participating in MIPS (the Merit-based Incentive Payment System) received their first round of […]