How physicians, hospitals and health systems should prepare for the operational and financial impact of 2021 E/M code changes
In this Q&A, Craig Joseph, MD, chief medical officer for Nordic Consulting Partners, provides insight into why physicians, hospitals and health systems should pay attention to new E/M coding guideline changes are going into effect on January 1, 2021.
Research examines whether financial challenges facing hospitals with large Medicare populations lead indirectly to cost shifting
Harvard researchers found evidence to suggest that hospitals with large shares of Medicare patients are at greater risk of being acquired, which can skew the market structure and lead to higher commercial prices.
Evolving approach to federal value-based payment models will emphasize equity, affordability
Leaders with CMS and the Center for Medicare & Medicaid Innovation have published a rough blueprint of the future of value-based payment at the federal level.
FY22 rule for the Inpatient Prospective Payment System finalizes a payment increase and key policy updates
The base payment increase for hospital inpatient services in FY22 will be 2.5%, according to a final rule issued by CMS.
Study: In price negotiations with hospitals, self-insured employers lack leverage
The vast difference in market power between hospitals and employers leaves the latter group with little recourse in negotiations, according to a new study.
In 2022 OPPS rule, CMS plans to reinstate policies pertaining to the inpatient-only and ASC covered-procedures lists
The 2022 proposed rule for the Outpatient Prospective Payment System would reverse 2021 policies that began to phase out the inpatient-only list of procedures and expand the covered-procedures list for ambulatory surgical centers.
CMS’s 2022 Medicare Physician Fee Schedule proposed rule: A look at telehealth provisions and overall payment rate changes
Clinicians will be able to seek payment for providing mental health visits to Medicare beneficiaries via audio-only telehealth, according to newly proposed regulations from CMS.
Hospital groups raise red flags about spending offsets in bipartisan infrastructure bill
The bill would be paid for in part by extending the duration of the 2% reduction in Medicare payments and by tapping into the Provider Relief Fund.
Medicare should update its policies for separately payable drugs in the Outpatient Prospective Payment System, MedPAC says
Worthwhile changes include requiring drugs to be proven clinically superior before granting them pass-through payment status, according to a new report.
Medicare indirect medical education payments to teaching hospitals should be overhauled, MedPAC says
Although the proposals represent a significant change, most hospitals wouldn’t be projected to experience a large impact on their payments.