The passage of the Patient Access and Medicare Protection Act was a significant win for healthcare providers stressed about being able to attest to meaningful use. The legislation, signed into law by President Obama in late December, allows eligible hospitals and eligible physicians to apply for a hardship exceptions under the 'unforeseen circumstances' category.

Higher out-of-pocket costs, new reimbursements models, and rising operating costs are just a few of the trends that will impact provider revenue cycles in 2016. These industry developments will force providers to evaluate existing Revenue Cycle Management strategies and possibly implement new technologies and workflows to simultaneously maintain financial health and address evolving consumer and regulatory demands.

2016: PQRS 2016 By the Numbers

CMS has released the Physician Quality Reporting System (PQRS) specifications for the 2016 reporting period and as previous years indicate, they are full of changes. Since inception, PQRS has greatly changed the coding and documentation landscape for Eligible Professionals (EP) and Group Practices. Reporting on quality measures has become a way of life for the practicing physician. Whether the reporting is being executed through a registry, allowed for most all standard measures and measure groups, or by individual physicians utilizing claims-based reporting, the additional time and monetary importance is not inconsequential. Physicians are being asked to do more and more each year so it’s vitally important for them to have an intuitive and robust system for collecting the data.

A focus on Patient Engagement will continue to lead the way for healthcare IT initiatives in 2016. Patients have, for decades, been stuck in the middle as doctors continued to communicate through antiquated methods…fax machines, paper scripts, little to no online presence, and the list goes on.

With increasing patient out-of-pocket requirements, eMDs expects to see the demand for technologies which can help practices estimate patient responsibility at or before time of service. Eligibility is moving upstream to start getting a more accurate payment estimation based upon plans. That can be a function of both eligibility and/or contracting depending upon the technology “solution” approach. There are quote marks around the solution because the reality is that no matter how much data moves back and forth, there are still industry realities which act as constraints.

In late October, the Centers for Medicare & Medicaid Services (CMS) issued the 2016 Medicare Physician Fee Schedule Final Rule updating payment policies, payment rates, and quality provisions for Medicare services furnished on or after January 1, 2016. The ruling covers a wide range of topics including a number of new policies, payment provisions as well as several quality provisions including updates to the Physician Quality Reporting System (PQRS) and the Physician Value-Based Payment Modifier (Value Modifier). In this post, we will examine the new provision for Advanced Care Planning. 

In late October, the Centers for Medicare & Medicaid Services (CMS) issued 2016 Medicare Physician Fee Schedule Final Rule updating payment policies, payment rates, and quality provisions for services furnished under the Medicare Physician Fee Schedule (PFS) on or after January 1, 2016. CMS finalized a number of new policies including a set of provisions designed to provide a smooth transition from the Value-Based Payment Modifier (Value Modifier) to MIPS.

The transition to ICD-10 was touted as the Y2K of the healthcare industry. After years of preparation and training the industry held its breath as October 1st came and went. But, much like Y2K, the predicted disaster never happened. In fact, according to a new survey by KPMG, 80% of organizations believe they have had a smooth transition to ICD-10. 

Information-rich patient records has made healthcare organizations a prime target for criminal entities. Royal Jay captures the severity of data breaches in a recent infogrpahic highlighting recent statistics from a Ponemon Institute study. Here are some statistics for you to consider: 

In late October, the Centers for Medicare & Medicaid Services (CMS) issued the 2016 Medicare Physician Fee Schedule Final Rule updating payment policies, payment rates, and quality provisions for Medicare services furnished on or after January 1, 2016.