Improving patient care and reducing healthcare costs will continue to be the top two challenges for the US healthcare industry in 2015. However, providers need to be prepared for various other regulatory changes this year that might prove challenging for the financial health of their practices. Here are the top five healthcare changes that providers will have to navigate through this year:
1. It is being predicted that partnership and collaboration among healthcare organizations will increase in order to survive the transition to value-based healthcare. These new partnerships will also include companies outside of healthcare. For instance, Anthem Blue Cross Blue Shield of Wisconsin recently collaborated with Aurora Health Care and the Aurora Accountable Care Network for a shared-risk program to support value-based payment models.
2. Meaningful Use stage 2 will create trouble for eligible professionals in 2015 as they will have to face a 1% decrease in Medicare reimbursement for not meeting the MU requirements. Penalty will increase by 1% every year and might go up to a maximum of 5%. Under Meaningful Use stage 2, providers have been given time until the end of February 2015 to ensure attestation.
3. Second phase of HIPAA audits started in October 2014 and will continue until June 2015. Providers will need to be prepared in case their practice gets audited for violating HIPAA requirements this year. 350 healthcare organizations will be asked for submitting information on patient health data security out of which around 150 will be audited. Fines for violation will start at $100 and might go as high as $50,000. Reputation of the practice will also get damaged in the market.
4. ICD-10 will be the biggest challenge faced by providers in 2015. With just eight months remaining for the compliance deadline, practices will have to prepare for potential revenue disruptions post implementation. According to a survey by the Medical Group Management Association in February 2014, 79% medical practices had not yet started preparing or were only somewhat ready. Transition to ICD-10 will prove expensive for many practices. They will have to keep some extra cash in hand to sail through revenue disruptions caused due to denials from miscoding.
5. Medical practices will feel the impact of the Affordable Care Act (ACA) on their reimbursement. ACA challenges will increase for providers working with Medicare patients. Failure to participate in the Physician Quality Reporting System (PQRS) will lead to penalties for physicians under ACA. They will face 1.5% penalty in Medicare payments in 2015 and this will increase to 2% thereafter.
In order to sail through healthcare challenges, many providers are opting to outsource their RCM to a third party. By choosing a reputed billing company such as MedicalBillersandCoders.com, providers have been able to improve cash flow and streamline their business functions.
MBC has an expert team of certified coders and billers who are well-trained in ensuring timely payments. They not only comply with reforms and use latest technology to handle RCM tasks but also help practices identify and solve problem areas in their revenue cycle.