Calling shots: The PHE will persist, billing snags loom, CCM will rise

Why This Topic Matters

The article helps readers gauge which regulatory and payment developments may influence practice operations, documentation, reimbursement, and audit risk in 2022.

Article Sections

1. 2022 predictions

   Introduces the annual outlook and the main topics expected to affect medical practices during the year.

2. Prediction: The COVID public health emergency (PHE) will continue into 2023

   Discusses expectations around the ongoing public health emergency, vaccination trends, and the broader direction of COVID-related policy.

3. Prediction: Facility-based split/shared policy will create coding errors, and CMS won’t offer additional guidance in the new year

   Covers anticipated operational and documentation issues tied to facility-based billing policy and the likelihood of limited additional guidance.

4. Prediction: Care management revenue will surpass $366 million in 2022

   Focuses on chronic care management and principal care management activity, payment trends, and how practices may respond to care management growth.

5. Prediction: Insurers will start to penalize the unvaccinated

   Looks at possible private-sector responses to vaccination status and how insurers might react.

6. Prediction: Telehealth flexibilities will go permanent beyond behavioral health in 2022

   Reviews the future of telehealth policy, related legislative activity, and concerns affecting access and utilization.

7. Prediction: Value-based models will be less episodic, more well-rounded

   Examines changes in value-based care strategy, CMMI priorities, and broader movement toward more comprehensive models.

8. Prediction: Audits will rise again, increasing compliance risk

   Addresses increasing audit activity, documentation response readiness, and compliance pressures tied to medical necessity and record requests.

9. Prediction: Expect surprises from the No Surprises Act — with good-faith estimates ambushing all practices

   Discusses early effects of the No Surprises Act, including patient estimate obligations and expected impacts on different specialties.