Amber Owens, MBA’s Post

With Medicare patients seeing specialists more frequently, #PrimaryCare teams must coordinate with more specialists than ever before, increasing the likelihood of fragmented care. To reduce fragmented care, CMS just announced a Request for Information (RFI) for a potential ambulatory specialty care model. It would test leveraging the Merit-based Incentive Payment System (MIPS) Value Pathways (MVPs) to increase the engagement of specialists in #ValueBasedCare and expand incentives for primary and #SpecialtyCare coordination. Visit the Calendar Year 2025 Medicare Physician Fee Schedule Proposed Rule fact sheet to learn more: https://go.cms.gov/45XA3b5

The delivery of affordable, high quality care requires efficient collaboration between primary care and specialists once a referral has been made. Formation of effective health policy requires similar collaboration. CMS is moving to integrate specialists within new episodic and longitudinal care payment models in the coming years. A shared common goal of reducing care fragmentation, duplication of services, and patient centric social and economic barriers to care within specialty referrals exists between payers and the over 40 medical and surgical specialities represented by the American Board of Medical Specialties (ABMS) and the American College of Surgeons. THE common benefactor of successful primary care delivery and care coordination within specialty referrals is the PATIENT. I encourage all specialty societies to engage in this MIPS/MVP RFI as scope-of-practice input is required to make MIPS and MVP more meaningful to patient care and less of a bureaucratic burden to care delivery. #specialtycare #Otolaryngology #Ophthalmology #Orthopedics #Cardiology #GeneralSurgery #Gastroenterology #OBGYN #Cardiothoracicsurgery #Vascularsurgery #Urology #Neurosurgery #oralmaxilofacialsurgery #oncology #Nephrology #Neurology #Dermatology #Rheumatology #Pulmonology

G2211 Add-on Code Reimbursement Policy - Horizon BCBS NJ For Medicare Advantage Products only: • Horizon BCBSNJ shall consider procedure code G2211 eligible when reported with a new and established patient office and outpatient E&M service. • Procedure Code G2211 shall not be considered eligible for reimbursement when the associated office and outpatient E&M visit is reported with Modifier 25. For Commercial Products only: • Horizon BCBSNJ shall not consider procedure code G2211. https://lnkd.in/d4scUW-B. #medicalcoding #ushealthcare #primedsolutions

Our Chronic Care Management partner, ChartSpan Medical Technologies, just received their most recent #Medicare claims data, and it’s now publicly available. For enrolled ChartSpan patients, #CCM can lead to: - 52% lower hospital readmission rates - 36% lower inpatient costs - 21% lower overall healthcare costs Check out the data here 👇 https://lnkd.in/ehpCet_s #qualitycare

Is your hospital getting everything it should for treating Medicare patients? Reimbursements for patient services in rural or geographically isolated hospitals vary. Most acute care hospitals receive payment according to the IPPS (Inpatient Prospective Payment System), but some receive adjustments based on specific criteria. Learn more by consulting this helpful chart: https://lnkd.in/gmyNiyw2

Medicare Offers Options Amid Shift to Value-Based Care. With the stated goal to transition all Medicare patients to value-based care arrangements by 2030, CMS has developed several fast-growing alternative payment models. TMA is focused on monitoring the models' development, educating physicians about their choices, and advocating for protections. https://hubs.li/Q02qDnRM0

Your voice matters! Find the full article at https://lnkd.in/gxy6s2wn —— In July, the Centers for Medicare and Medicaid Services (CMS) proposed rescinding the Appropriate Use Criteria (AUC) rules and policy as part of the Medicare 2024 Physician Fee Schedule (MPFS) proposed rule. This was huge. With these changes came the opportunity for feedback. The RBMA responded on behalf of its members and their comments reflected concerns about key issues in the proposed legislation. Yet, this is a complex issue and the policy could have greatly benefited from your unique perspective and expertise in radiology as well. While the comment period has passed, let this policy change serve as a reminder of the importance of comments and questions in response to proposed rule making in the future. Let your voice (and your practice's) be heard!

Join our 2024 CPT Updates Webinar to review important changes to the CPT guidelines. plus bonus information & key items from the 2024 Medicare Physician Fee Schedule. Register to watch on-demand starting 12/7: https://hubs.la/Q02bj0Jv0 #codingwebinar #medicalcoding #cpt #2024cpt

Medicare billing can be a beast. 😱 With the recent Physician Fee Schedule Proposed Rule for 2025 and more change on the horizon, it's a great time to brush up on best practices. Here's your comprehensive guide to Medicare reimbursements and physical therapy: https://vist.ly/3fgr7

Is your team drowning in regulatory updates? Are you concerned about maintaining compliance when everything is constantly changing? CMS (Centers for Medicare and Medicaid Services) finalized payment rates for the Hospital Outpatient Prospective Payment System (OPPS) and the Ambulatory Surgical Center (ACS) for 2024. The final rules include a payment update of 3.1 % and additional changes to hospital price transparency requirements. Clearfork Digital can ensure you are always compliant and take advantage of updates that favorably impact your bottom line. Learn more at https://lnkd.in/gzy_pm-9