The survey found that median provider salary and benefits expense as a percent of net revenue increased from 72.1 percent to 84.9 percent, which is the outcome of provider compensation being protected during the COVID-19 pandemic combined with decreased productivity. In addition, the survey showed a net revenue decrease from 24.2 percent to 22.8 percent […]
The Centers for Medicare & Medicaid Services (CMS) has finalized 2022 payments and policies under the Medicare Physician Fee Schedule (MPFS). The rule includes updates to payment rates for physicians and other healthcare professionals for calendar year (CY) 2022; expands the use of telehealth for mental health; clarifies policies related to split (shared) visits, critical […]
The pandemic has changed patients’ use and perceptions of healthcare organizations. The question remains: Will those changes here to stay? PATIENTS PREFER TELEHEALTH SERVICES FROM DOCTORS, HEALTH PLANS Most telehealth users accessed virtual care services through their regular doctor or health plan as opposed to direct-to-consumer telehealth platforms, according to new data from Morning […]
Providers’ experiences with Medicare Advantage plans’ capitated payment models, supplemental benefits, and overall influence gave them recommendations for CMS. There has been a lot of valuable conversation around the benefits that Medicare Advantage health plans can offer to consumers, but now providers have offered their perspectives on this form of health insurance in Better Medicare […]
CMS says it the goal is to support health equity while focusing on high-quality person-centered care. Increased leverage of telehealth for behavioral care, diabetes prevention and mitigation, and enhanced payment for vaccine administration were three out of many priorities cited by federal officials who announced the release of the Centers for Medicare & Medicaid […]
Provider-sponsored health plans can be naturally aligned with value-based care goals while also being attuned to providers’ needs. Providence Health Assurance’s Medicare Advantage provider-sponsored health plan received a five-star rating through the CMS Medicare Advantage Star Ratings system for the 2022 Medicare open enrollment season. The health plan, which serves Oregon and Washington State, is […]
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. […]
‘If you can get it right up front, you’re ensuring accuracy, preventing rework, and preventing denials,’ says Alicia Auman, director of patient access at KSB Hospital. Patient access plays a tremendously important role within the revenue cycle, which is why Alicia Auman, director of patient access at KSB Hospital in Dixon, Illinois, has worked […]
“Medicare Advantage plans have a unique and growing opportunity to address the needs of socioeconomically vulnerable populations and improve their health,” reports America’s Health Insurance Plans. More plans for individuals with low incomes, as well as targeted SDOH investments and initiatives, round out carrier approaches. On the benefits side, offerings such as meals, transportation, […]
The data, released Thursday by the Centers for Medicare & Medicaid Services (CMS), come as ACO advocates want the agency to give organizations more options to take on financial risk. CMS has shuttered the program in favor of the Direct Contracting model. “Many Next Gen ACOs aren’t moving into Direct Contracting and have expressed a […]