Health Care Business Advisor
Providers are pushing back against the proposed codes to identify which clinicians provide services as promulgated in the draft MACRA rules. The codes are a key component of the payment reform, since they will be utilized to compare resource utilization and outcomes. Industry leaders say the proposed patient relationship codes, which were mandated by the […]
Over 400 Medicare accountable care organizations generated more than $466 million in total program savings in 2015, according to the latest data from CMS. However, Medicare spent $217 million more in bonuses than the ACO program saved. The data is from the financial results of 392 organizations participating in the Medicare Shared Savings Program and […]
I am pleased to comment on the proposed Revisions to Payment Policies Under the Physician Fee Schedule and Other Revisions to Part B for CY 2017 for doctors and other clinicians under Medicare. In the Notice of Proposed Rule making,published July 15, 2016 (CMS-1654-P), you seek comment on the implementation of changes to Medicare’s payments […]
There are a couple of similarities as well as a couple of differences between Chronic Care Management (CCM) and Care Plan Oversight (CPO). Medicare only pays for CPO for beneficiaries who are receiving Medicare home health or Medicare hospice. CPO is similar to CCM because it requires tracking on task for non-face-to-face services, so a […]
CPC+ is a mutli-payer model. It will only be offered in regions where Medicaid and private payers have offered to participate along with Medicare. 1.Which payers will be involved? This will vary from region to region. We will know who is involved in each region as soon as the payer bid cycle is concluded (those […]
Comprehensive Primary Care Plus (CPC+) is a national advanced primary care medical home model that will include two primary care practice tracks with incrementally advanced care delivery requirements and payment options. CPC+ is a five-year model that will begin in January 2017. Practices choosing to participate in CPC+ cannot participate in CCM or an ACO […]