Tag: Payment models

CPT® codes play a pivotal role in the transition to value-based care

In order for value-based healthcare to succeed, it is imperative that physician practices effectively articulate the medical services and procedures they provide. This underscores the vital role of the Current Procedural Terminology (CPT®) code set in driving the shift towards value-based care. According to the chair of the AMA/Specialty Society Relative Value Scale Update Committee (RUC), […]
How physicians can untangle the web of relationships essential for value-based care success

How physicians can untangle the web of relationships essential for value-based care success

Primary care physicians (PCPs) and other physicians continue to migrate away from the traditional fee-for-service (FFS) reimbursement model toward value-based and risk-bearing care models that reward better outcomes and reduced healthcare costs. Value-based care (VBC) contracts are projected by McKinsey to cover nearly 65 million Americans, or 22% of insured lives, by 2025, up from […]
medicare-drops-end-stage-renal-disease-payment-rule-aims-to-close-health-equity-gaps

Medicare drops end-stage renal disease payment rule that aims to close health equity gaps

The Biden administration dropped a final rule Friday that will reward providers that improve rates of home dialysis and kidney transplants among low-income Medicare and dual-eligible beneficiaries. The goal of the changes is to encourage dialysis providers to decrease disparities in home dialysis and transplant rates, part of a larger effort by the Biden administration. […]
MIPS-Payment Models

CMS Unveils New MIPS ‘Framework’ Aimed at Reducing Reporting Burden

The Trump administration has proposed updates to the Merit-based Incentive Payment System (MIPS) it says would ease the quality reporting burdens in the program. The Centers for Medicare & Medicaid Services (CMS) introduced a new framework for MIPS called MIPS Value Pathways (MVPs) with the goal of making it easier for physicians to participate in the program. Under […]