Physicians start to feel the financial
pinch from regulations.
2015 Introduced:
Value-based purchasing programs are solidly in
place for hospitals. But now, eligible physicians are starting to feel the
penalty phase of CMS’s quality reporting and Meaningful Use initiatives.
In fact, CMS revealed that more than 257,000 eligible professional providers
who are not meaningful users of certified EHR technology would have their
Medicare Fee Schedule cut by one percent in 2015. Eligible professionals may
also see reductions in reimbursements for noncompliance with Medicare’s
Electronic Prescribing (eRx) Incentive Program and the Physician Quality
Reporting System (PQRS).
Eligible physicians also need to comply with
CMS’s new Value-Based Payment Modifier program, or face penalties.
The Value-Based Modifier program calculates Medicare’s payments to physicians
in group practices based on annual cost and quality measures. It’s part of
Medicare’s efforts to improve healthcare, but the program adds yet more
regulations physicians need to monitor.
All these changes and new reporting
requirements are overwhelming busy physicians, which is why the American
Medical Association has repeatedly asked for relief.
There is some positive news for physicians,
however. CMS passed a final rule to allow for a new procedural terminology
(CPT) code, 99490. The code enables physicians to bill CMS $41.92 per month for
providing remote chronic care management to qualifying patients.
Another positive note for physicians, more
states under Medicaid and commercial payers are adding telemedicine to their
reimbursement fee schedule, so physicians can bill for these services.
2016
On October 14, 2016, the final rule on the Medicare Access
and CHIP Re-authorization Act of 2015 (MACRA) was published. MACRA sunsets
existing fee-for-service reporting programs like Meaningful Use (MU) and PQRS
and replaces it with a new pay-for-performance program, the Merit-based
Incentive Payment System (MIPS).
MIPS consolidates
and strengthens the financial impacts of the Meaningful Use (MU),
Physician Quality Reporting System (PQRS), and Value-Based Modifier (VBM)
programs, while leveraging
their respective rules.
Do
providers have time to review , comprehend and implement all these regulations
to meet today’s healthcare ?
The
best system for driving, measuring, and sustaining healthcare process improvement
involves expertise knowledge.
SILBEN
Healthcare Services offers the experience necessary to meet these changes. A
healthcare system’s success will depend on the ability and willingness to
collaborate creatively with payers in order to get sustainably paid and deliver
better care.
For more details , contact:
SILBEN Healthcare Services, INC.
Paul G. Silverio-Benet
Phone: 305-975-1171
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