CMS looks to fortify primary care with proposed new codes for advanced care management
With newly proposed regulations, CMS aims to establish coding and payment for services that promote longitudinal relationships between clinicians and patients in primary care. The provisions, part of Medicare’s 2025 proposed rule for physician payments, incorporate new HCPCS G-codes for advanced primary care management (APCM). Three bundles of APCM services would be billable as codes…
The “dystopian” state of primary care
Dr. Vishnukamal Golla discusses the challenges facing primary care physicians and their patients. News team Nick Hut and Shawn Stack provide an update on the Change Healthcare cyberattack and other current events.
Recent updates and emerging best practices for ACOs in the Medicare Shared Savings Program
Going into the 12th year since it brought accountable care into the healthcare lexicon, the Medicare Shared Savings Program (MSSP) continues to evolve, with CMS making changes and participants fine-tuning best practices. Starting with 220 accountable care organizations (ACOs) in 2012-13, the MSSP grew to 561 in 2018. However, the number has been below 500…
Gail Wilensky: How the pandemic created a new impetus for improved care coordination
The COVID-19 pandemic proved to be a catalyst for many significant changes in healthcare delivery. Some were intentional, representing seized opportunities to improve processes. But other changes were forced on the industry as a result of constraints imposed by the pandemic. One of the most significant of these changes, for example, has been the industry’s…
Data indicate hospital operational logjams haven’t ceased after the public health emergency (updated)
Note: The fourth section of this article has been updated with news of proposed mandatory staffing ratios for long-term care facilities. Some of the problems that strained hospital operations during the peak of the COVID-19 pandemic have eased, but not enough to mark a true industrywide recovery, a recently released report suggests. Notably, the process…
Healthcare News of Note: 5% of U.S. adults are forgoing healthcare due to transportation barriers
This blog share synopses of three stories for healthcare finance professionals, including Adults with transportation issues forgo needed healthcare and pediatric hospital admissions involving ICU care are increasing.
Healthcare News of Note: Healthcare private equity deals amounted to a strong $90B in 2022
In 2022, healthcare private equity deals reached nearly $90 billion, the second highest on record. Concerns about increased workloads, staffing shortages and burnout have been felt most acutely by less experienced nurses, according to a newly published study. Patients seeking care in safety-net clinics are accruing chronic diseases at high rates in middle age, indicating…
In federal ACO programs, advocates see signs of slow but steady progress
Growth in accountable care organization (ACO) programs has been inconsistent since the Affordable Care Act made accountable care part of the healthcare lexicon in 2010. Nonetheless, proponents are optimistic about the state of ACOs and their potential in upcoming years, even if there’s uncertainty about CMS’s ability to achieve its stated goal of ensuring every…
Healthcare News of Note: 7 hospitals earn a Press Ganey award for outstanding nursing quality
Seven hospitals were recognized for elevating nursing excellence and improving patient outcomes with Press Ganey’s National Database of Nursing Quality Indicators Award for Outstanding Nursing Quality. Only 48% of Americans rank the quality of U.S. healthcare as excellent or good, according to results of a Gallup Health and Healthcare survey. Nearly half of Americans are…
Healthcare News of Note: Is a public health crisis looming for the generation born during the pandemic?
Infants born during the pandemic, regardless of maternal SARS-CoV-2 status, scored significantly lower on the gross motor, fine motor and personal-social subdomains of the Ages & Stages Questionnaire, 3rd Edition when compared with a cohort born pre-pandemic at one hospital. Opioids were prescribed at discharge during fewer emergency department (ED) visits in 2019-20, compared with…