Our 2015 predictions: SGR was a shock, ICD-10 a breeze; the rest PBN called

Why This Topic Matters

It helps coding and practice management professionals understand how major federal initiatives affected provider behavior, reporting adoption, and payment policy in 2015, and it places those changes in the context of operational and compliance concerns.

Article Sections

1. Predictions: How we did

   An overview of the article’s retrospective on 2015 predictions and the major healthcare policy areas being assessed.

2. Prediction: Oct. 1, 2015, will mark the beginning of the ICD-10 era, and the start will be shaky.

   Discussion of the ICD-10 transition and the general experience of the launch period for practices and claims processing.

3. Prediction: More practices will attest for stage 2 meaningful use, yet not enough to avoid further delays or exceptions.

   Coverage of meaningful use participation trends and CMS adjustments to the program’s requirements.

4. Prediction: Providers will wait for worse penalties to comply with the physician quality reporting system (PQRS).

   A review of provider participation in PQRS and the role of payment adjustments in compliance behavior.

5. Prediction: Health IT vendors will improve options for PQRS reporting.

   Discussion of technology support for quality reporting and the challenges providers faced with reporting systems.

6. Prediction: Providers will be slow to adopt billing for chronic care management (CCM).

   Coverage of chronic care management adoption, related administrative barriers, and early billing activity.

7. Prediction: Health IT companies will come up with CCM-related products.

   Overview of vendor activity and product development around chronic care management services and support.

8. Prediction: A temporary “doc fix” will avoid large Medicare cuts but a permanent fix will elude providers again.

   Discussion of Medicare payment legislation, the end of the sustainable growth rate approach, and the shift toward performance-based payment.

9. Prediction: Practices will suffer the financial repercussions of not understanding incentive and quality reporting programs or coding rules.

   Coverage of compliance exposure, audits, repayments, and broader financial risks tied to federal program requirements.

10. Prediction: Physicians will delve into preventive care, other office-based services to offset reimbursement cuts.

    A look at how physicians may respond to reimbursement pressure by expanding office-based and preventive services.