By John W. McDaniel bio Hospitals are seeking new and innovative ways to affiliate with physicians that differ from tactics used in the 1990s, These new relationships involve a more formal type of relationship with physicians, which might reflect lessons learned through previous less‐than‐satisfactory relationships. Most hospitals have physician integration strategies as a … [Read more...] about The physician enterprise model: a non-employment alternative
Increasing profits
The new paradigm for physician compensation: payment for value/quality v. volume
By John McDaniel bio How will physician compensation arrangements be impacted by quality incentive payments with respect to determining Fair Market Value and commercial reasonability? The enactment of the Medicare Access and CHIP Reauthorization Act (MACRA) in November 2016 set forth future options for payment from Medicare, those being participation in the Merit‐Based … [Read more...] about The new paradigm for physician compensation: payment for value/quality v. volume
New deadline of Dec. 13 to update APM Incentive billing info
Is your office among the clinicians that need to verify Medicare billing information by Dec. 13 in order to receive payments? The Centers for Medicare & Medicaid Services (CMS) Quality Payment Program website includes 2020 Alternative Payment Model (APM) Incentive Payment details. To access information on the incentive amount and organization paid, clinicians and surrogates … [Read more...] about New deadline of Dec. 13 to update APM Incentive billing info
Impact of 2021 evaluation and management coding changes to WRVU based physician compensation
By John McDaniel bio As you may know, all physician contracts which include any form of WRVU based compensation will need to be reviewed and probably amended due to the increase in WRVUs (work relative value units) associated with E&M CPT codes effective Jan. 1, 2021. We recently conducted an assessment for one of our hospital clients which showed the ʺunintended … [Read more...] about Impact of 2021 evaluation and management coding changes to WRVU based physician compensation
Deadline Oct. 5 to ask for MIPS targeted review
If you participated in the Merit-based Incentive Payment System (MIPS) in 2019, your performance feedback, including your MIPS final score and payment adjustment factor(s), is now available for review on the Quality Payment Program website. This final score determines the payment adjustment you will receive in 2021, with a positive, negative, or neutral payment adjustment … [Read more...] about Deadline Oct. 5 to ask for MIPS targeted review
Life science companies and healthcare providers partnering for value-based patient care
By Mal Milburn bio In the era of value-based reimbursement, healthcare professionals are constantly evaluating strategies to improve patient care while simultaneously decreasing overhead costs. Increasingly, medical practices turning to life science reps as a critical part of the answer. According to recent research from DRG Digital Manhattan Research, 74% of … [Read more...] about Life science companies and healthcare providers partnering for value-based patient care
Five ways to boost practice efficiency on a shoestring budget
By Karen Mattocks bio It is every manager’s mantra: ‘Do more with the same number of staff.’ Translation? See more patients. Submit more claims. Generate more revenue—all while providing high-quality, low-cost care. How do successful managers accomplish this? They remove the organizational-level barriers that drain productivity, says Michael Mankins, co-author of Time, Talent, … [Read more...] about Five ways to boost practice efficiency on a shoestring budget
7 free or low-cost ways to increase practice efficiency
By Jeremy Gilman bio It is a question practice managers ask themselves daily: ‘How can I accomplish more tasks using the same—or even fewer—resources?’ Times are tough. For many providers, increased access to healthcare care under the Affordable Care Act has translated to increased patient volume, and not every practice is equipped to handle the demands. Couple this with … [Read more...] about 7 free or low-cost ways to increase practice efficiency
2019 Performance Period Suppressed MIPS Quality Measures
In the 2019 Physician Fee Schedule Final Rule (83 FR 59847), the Centers for Medicare & Medicaid Services (CMS) established a policy that provides for the suppression of measures in certain circumstances. Starting with the 2019 performance period, for measures significantly impacted by clinical guideline changes or other changes where the CMS believes that adherence to … [Read more...] about 2019 Performance Period Suppressed MIPS Quality Measures
MIPS data submission deadline extended to April 30
The 2019 Merit-based Incentive Payment System (MIPS) data submission deadline has been extended by 30 days to April 30, 2020. In general, if you have already submitted MIPS data or if you submit MIPS data by April 30, 2020, you will be scored and receive a MIPS payment adjustment based on the data you submit. Many MIPS eligible clinicians have performed very well in the MIPS … [Read more...] about MIPS data submission deadline extended to April 30