Medicare to Change How it Pays Doctors and Hospitals

The Obama administration outlined ambitious new goals Monday to transform over the next four years the way that the gargantuan Medicare program pays doctors and hospitals, rewarding providers that achieve better outcomes for patients rather than those that just do more.

The move away from so-called fee-for-service medicine is a central, if little recognized, goal of the Affordable Care Act, which the president signed five years ago.

Most experts believe that this shift is crucial to improving the quality of care that patients receive, while also restraining costs at a time when millions of baby boomers will be entering the nation's primary insurance program for the elderly.

Under the goals announced Monday, Medicare will make 30 percent of its direct payments to doctors, hospitals and other providers through alternative payment models by next year, up from nearly nothing four years ago.

These models include bonuses for doctors to coordinate patients' care and programs that set a budget for patient care and reward physician practices, hospitals and others who deliver the care under budget while achieving good outcomes for patients.

By 2018, half of Medicare's direct payments to providers should be through such models, according to the federal Department of Health and Human Services.

Continue reading on msn.com

More Items in January 2015

• Jan 30, 2015
  PQRS CMS.gov Interactive Timeline - Don't Miss the Deadlines!
• Jan 30, 2015
  CMS Opt-Out Regulations and Guidelines
• Jan 28, 2015
  Value Set Authority Center (VSAC)
• Jan 28, 2015
  Underdosing - a New Clinical Concept in ICD-10 codes T36 - T50
• Jan 23, 2015
  New: 2015 January Edition of the Medicare Quarterly Provider Compliance Newsletter
• Jan 23, 2015
  Eligible Professional 2014 Attestation Deadline on February 28; Prepare for Attestation
• Jan 14, 2015
  Billing for Split Unit of Blood
• Jan 14, 2015
  Aligning the Way Providers are Paid to Reward Value Rather than Volume (Value Based Modifiers)
• Jan 14, 2015
  What is an LMRP and Where Can I Find Them?
• Jan 06, 2015
  Holding of 2015 Date-of-Service Claims for Services Paid Under the 2015 Medicare Physician Fee Schedule
• Jan 06, 2015
  Modifier -59 Could Impact Your Reimbursement - New Coding Requirements!
• Jan 01, 2015
  New This Month (January 2015)

To view more items select a month from our "Items by Month" list.

Or view documentation, coding and billing articles.