CMS and the Department of Health and Human Services (HHS) released the 2023 Notice of Benefits and Payment Parameters Final Rule, which includes standardized plan options, changes to network adequacy reviews, refinements to the Affordable Care Act’s essential health benefits nondiscrimination policy, and other changes. “The recent Open Enrollment Period demonstrated the demand for […]
Revenue cycle leaders noted that the confusing regulations included in the CMS price transparency rule make it difficult for their organizations to achieve compliance. The majority of revenue cycle leaders were dissatisfied with aspects of the CMS hospital price transparency rule and expressed doubt about the regulation’s efficacy, according to a KLAS report RevCycleIntelligence received […]
With Tax Day on the horizon, don’t fall into these specific traps. Our last installment provided some details and basic rules every doctor should know about tax planning, including who is responsible for the information on your tax return, details about what income you have to report, and a look at the sales techniques promoters […]
Medicare Advantage beneficiaries who received care under value-based payment models, including two-sided risk models, saw lower acute care use than beneficiaries under a fee-for-service model. Medicare Advantage beneficiaries whose primary care organization participated in a value-based payment model saw lower rates of hospitalizations, observation stays, and emergency department visits, according to a study published in […]
Office visits represented 48 percent of all telehealth services used in the first year of the pandemic, making it the service most accessed via telehealth, federal data shows. Medicare beneficiaries most often used telehealth for office visits in 2020, receiving 54.5 million virtual office visits in the first year of the COVID-19 pandemic, according to […]
The American Medical Association urged congressional leaders to lift the freeze on Medicare physician payments and provide updates that reflect inflation and practice costs. Following a recent Medicare Payment Advisory Commission (MedPAC) report, the American Medical Association (AMA) has asked Congress to update the Medicare physician payment system to include a stable annual payment rate […]
Patient self-service is key for providers to keep pace with the evolution of healthcare consumerism. Catch a flight recently? Odds are, you booked your tickets online. Visited a bank? There’s a good chance you used an ATM. Just think about the last time you went to the grocery store: How long was the self-checkout line? […]
States should prepare for fluctuations in Medicaid spending on nonelderly acute care after the declaration ends. The end of the coronavirus public health emergency declaration could lead to a shift in Medicaid spending for state Medicaid programs and federal Medicaid costs, according to a report from the Robert Wood Johnson Foundation and Urban Institute. States […]
CMS encouraged Medicare Advantage plans to waive prior authorizations during the public health emergency, but AHA urged the agency to make it a requirement instead of a suggestion. The American Hospital Association (AHA) has asked CMS to work with Congress and require Medicare Advantage plans to waive prior authorization processes during the current and future […]
There are barriers to telehealth adoption that physicians must overcome to realize the technology’s promise. Telehealth clearly has crossed a threshold of acceptance and now is viewed by physicians, payers and patients as an essential part of healthcare. It’s no surprise Fortune Business Insights predicts the telehealth market will reach $636.4 billion by 2027. […]