CMS is going to make key changes to Bundled Payments for Care Improvement (BPCI) Advanced next year to stop the model from generating financial losses of close to $2 billion over the model’s ten performance periods. Model year 4 will begin on Jan 1, 2021. CMS’s Innovation Center will modify target pricing calculations using an […]
The Medicare Payment Advisory Commission (MedPAC) is the latest group to evaluate telehealth reimbursement expansions post COVID-19 pandemic. In a meeting held virtually in the start of September 2020, MedPAC analysts Ariel Winter and Ledia Tabor shared some policy ideas for keeping telehealth coverage and reimbursement expansions post the pandemic now that providers across the […]
According to a new survey that confusion over COVID-19 medical coding and insurance claim requirements is one of the top effects the pandemic has had on revenue cycle management in the healthcare industry. Alpha Health conducted a survey through the Healthcare Financial Management Association’s Pulse program, they inquired 587 chief financial authorities and revenue cycle […]
The Healthcare industry is facing implications from the pandemic situations that can impact their ability to improve contract performance and potentially expose them to new risks. Value-based contracts are usually relying on historical data for starting claim targets, trend rates, and/or quality measures. Impact on claims The timing and severity of this pandemic situation is […]
The American Hospital Association (AHA) is calling on CMS to re-evaluate payment options for hospitals that accepted accelerated Medicare payments at the early stage of the COVID-19 pandemic. The hospital group requested CMS Administrator Seema Verma to allow all hospitals to elect to receive periodic interim payments (PIP) or accelerated payments, per initial CMS communications […]
The CMS (Centers for Medicare and Medicaid Services) and CDC (Centers for Disease Control and Prevention) recently announced provider reimbursement update available to physicians and health care providers to counsel patients, at the time of coronavirus disease 2019 (COVID-19) testing. Providers educate patients about the importance of self-isolation once they are tested and prior to […]
Early in August 2020, the Medicare Accelerated & Advance Payment Programs will start to recover the $100 billion in Medicare reimbursements advanced to hospitals and physicians to ease cash flow issues they experienced in March when a handful of COVID-19 cases turned into a national public health emergency. Major hospital groups are asking Congress to […]
The paycheck protection program is a key resource for small healthcare organizations and the program is established by the Coronavirus Aid, Relief, and Economic Security (CARES) Act. This act provides loans up to USD 10 million for businesses with fewer than 500 total employees. The loans can be fully forgiven if at least 60 percent […]
Oncology practitioners in CMS’s Oncology care model (OCM) are willing to take on two-sided risk, according to the Community Oncology Alliance (COA) survey. The oncology practitioners are confident they can get success in providing quality and cost-effective cancer care as the healthcare system undergoes the shift from fee-for-service to value-based care. Community Oncology Alliance surveyed […]
“Account Receivable” (AR) is a widely used term referring to the amount of money that a customer owes to the company. Similarly, in the healthcare industry, AR means the patient’s account balance becomes due for payment within a year. Account receivable services include the management of many reports dealing with insurance, collection analysis, write-offs, bad debt […]
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